MONORADICULOPATHY OF THE 5TH LUMBAR NERVE ROOT DUE TO LUMBAR DISC HERNIATION BETWEEN LUMBAR ONE AND LUMBAR 2 VERTEBRAE

An extremely rare case is reported of a 34-year-old man who had a drop foot due to a herniated disc between the first and second lumbar vert ebrae with a monoradiculopathy of the fifth lumbar nerve root. The dia gnosis was made on the basis of myelography and magnetic resonance ima ging (MRI), which revealed a disc centrolateral herniation at the leve l between the first and second lumbar vertebrae. The patient underwent anterior discectomy and fusion with the use of iliac bone graft. Beca use of increasing local kyphosis and associated symptoms, a posterior TSRH instrumentation was added successfully. Postoperatively the patie nt had alleviation of his symptoms, and at the 6-year follow-up evalua tion, he was completely symptomless. The spine surgeon should be aware of the possibility of this rare location of lower lumbar nerve root c ompression within the dural sac. In such a case, myelography and MRI s eemed to be superior to the computed tomography scan.