The patient had been suffering from lumbar pain, to the right side, radiating into the sole of the foot with paraesthesia in the big toe , for 4-5 months.
The onset was slow, getting slowly worse. At the moment of the visit, all those symptoms were gone and his main complaint was a sort of insensibility in the inguinal region to the right during the last two months.
He's been treated for the pain with muscle relaxant medication and non-steroidal anti-inflammatory drugs during three-four weeks. The inspection was negative. The palpation revealed a slight pain localized on L5 during the extension pressure on the spinous process of L5. The basic functional examination revealed a well defined sensory deficit in the inguinal region ; all the other tests were negative.
The patient, before coming to me, underwent a CT scan of the lumbar spine which showed "an intraforaminal herniation of the first disc to the right, in evident conflict with L1 root".
Conclusion: the scan report and the clinical examination showed the same picture.
No treatment was needed because of the presence of a sensory neurological deficit: a very rare case of L1 protrusion. Await spontaneous cure.
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