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CSF cytology and HIV serology were both negative. EMG, however, confirmed the clinical findings of polyradiculopathy. T1W and T2W MRI of the lumbar spine demonstrated diffuse thickening of the nerve roots of the cauda equina, which enhanced following intravenous gadolinium administration (Figs. 1 and 2). No parenchymal involvement was seen.
Lumbar intervertebral disc herniation occurs most commonly at L4/5 (L5 root; 50%) and at L5/S1 (S1 root; 46.3%). Therefore, compression of the 5th lumbar nerve root is most common, with the first sacral nerve roots a close second.ver 90% of all clinically significant lower extremity radiculopathies due to disc herniation involve the L5 or S1 nerve root at the L4-5 or L5-S1 disc level. The natural history of most disc herniation is that the symptoms are self-limited and do not require surgical therapy.