The 56-year-old female patient presented here has been complaining of pain in the region of the caudal lumbar spine with bilateral radiation paravertebrally, as well as right laterally into the lower extremity for about a year. There would be a slight relief with prevention, no change of the complaints in sitting or standing.
A-C: Sagittal images in the sitting position: Inclination, neutral position, reclination
D: Axial image in sitting position in neutral upright body position
Diagnosis: Upright MRI scans, upright under natural weight bearing, show dorsal displacement of L4 relative to L5 without significant narrowing of the ventrodorsal diameter of the spinal canal. There is no significant change in vertebral slip in the inclination and reclination positions.
In addition to a right mediolateral disc prolapse, the functional radiographs only clearly delineate a sequestrum in the inclination position, which can only be guessed at in the neutral and extension positions. Furthermore, degenerative changes in the sense of a MODIC I as well as disc protrusions in the segments L2-L4 can be seen in the corresponding segment subcortically.