• Axial and sagittal T2 and T1 slices are key to diagnosis.
• Look for disc material herniating into the canal, lateral recess or exit foramina.
• Lateral disc protrusion passes into the exit foramen and compresses the exiting root (symptoms are the same as a central protrusion at the level above).
• Check for signal change within the cord on T2 (i.e. cord compression).
• Check for associated facet joint degeneration and thickening of the ligamentum flavum.
• Sequestrated fragments may migrate caudally/cranially/become intradural.
• Sequestered fragments may become surrounded by granulation tissue and enhance with contrast.
• Post-operatively, look for non-enhancing disc material (recurrence); enhancement of disc material suggests fibrosis and scarring.
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