UPPER LUMBAR DISC PROLAPSE

Upper lumbar disc prolapse (ULDP) is a rare and a unique clinical entity which has a potentially devastating clinical outcome. It may manifest with low back or anterior thigh pain, polyradiculopathies (from spinal cord or cauda equina compression) and/or degenerative kyphoscoliosis. Its diagnosis is often difficult and may be missed because of the lack of specific root signs. Magnetic resonance imaging is the diagnostic modality of choice. Anterior, posterior and endoscopic approaches have been explored in the treatment of this pathology. However, the treatment outcome for ULDP has been found to be poorer compared to that of similar herniations at lower spinal levels. We report this case to draw attention to the need for a high index of suspicion to make the correct diagnosis.