Lumbar Spine Herniated Disk

This patient had severe back and leg pain. An MRI scan was ordered. A sagittal sat-saturated, post-gadolinium T1-weighted image reveals a "herniated disk" with a large free disk fragment (arrow) posterior to the L4-L5 intervertebral disk. The disk fragment is outlined by enhancing granulation tissue. This patient underwent surgery for removal of the free disk fragment, and experienced complete relief of his pain.