Giant foramen disc herniation with pedicle hypoplasia:a case report and review of the literature

Low back pain and radiculopathy of lower extremities caused by lumbar disc herniation is one of the most common causes of spinal surgery outpatients. Differentiating a large lumbar disc herniation from other conditions that consume space in the spinal canal is necessary. We present a case with a giant foramen disc herniation with pedicle hypoplasia. This case provides valuable insights for distinguishing this condition from other possible diagnoses. The Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines were followed in establishing this case report. A 75-year-old female showed low back pain and numbness in the left lower limb. The imaging examination revealed a large prolapse of the intervertebral disc in the region of the left intervertebral foramen of the L4 vertebra, together with an L4 pedicle dysplasia. Due to the presence of different common illnesses and pedicle dysplasia, pedicle screw internal fixation is not recommended. After percutaneous endoscopic lumbar discectomy, the patient recovered well and the symptoms disappeared. Given the aberrant pedicle development on the left side of L4 and the intervertebral disc prolapse in the left intervertebral foramen area of L4, giant lumbar disc herniation should be differentiated from other space-occupying disorders in the spinal canal. However, other space-occupying lesions, especially tumors, tend to destroy the pedicle of the vertebra, so it is necessary to make a surgical plan after adequate differential diagnosis.