What is the level of disc prolapse in a lady with reduced extension, intact sensation & pain in great toe but with no sphincter disturbance ?
Correct answer : B. L4-L5
Extension of great toe is by extensor hallucis longus muscle. It is supplied by deep peroneal nerve (L5, S1). L5 nerve root is involved in disc prolapse at L4-L5 level. The patient has pain without sensory loss due to irritation of the nerve. Complete damage results in sensory loss, whereas irritation of nerve results in pain.
Ref: Hutchison’s clinical methods, 22nd p211; Maheshwari 3rd p231
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