Monoradiculopathy of the fifth lumbar nerve root due to lumbar disc herniation between lumbar one and lumbar two vertebrae.

An extremely rare case is reported of a 34-year-old man who had a drop foot due to a herniated disc between the first and second lumbar vertebrae with a monoradiculopathy of the fifth lumbar nerve root. The diagnosis was made on the basis of myelography and magnetic resonance imaging (MRI), which revealed a disc centrolateral herniation at the level between the first and second lumbar vertebrae. The patient underwent anterior discectomy and fusion with the use of iliac bone graft. Because of increasing local kyphosis and associated symptoms, a posterior TSRH instrumentation was added successfully. Postoperatively the patient had alleviation of his symptoms, and at the 6-year follow-up evaluation, he was completely symptomless. The spine surgeon should be aware of the possibility of this rare location of lower lumbar nerve root compression within the dural sac. In such a case, myelography and MRI seemed to be superior to the computed tomography scan.