This composite figure demonstrates the preoperative, intraoperative, and postoperative findings of a 60-year-old patient with lateral recess stenosis and L4/5 disc herniation treated with visualized reamed foraminoplasty (VRF). Panels A and B (MRI) and Panel C (CT) represent preoperative imaging, showing significant narrowing of the right lateral recess and compression of the L5 nerve root at the L4/5 level. Panel D is an intraoperative endoscopic photograph showing the L5 nerve root fully released and decompressed. The nerve appears as a white, elongated structure against reddish surgical tissue; directional labels (Dorsal, Ventral, Cranial, Caudal) orient the viewer to the surgical field. Panels E (MRI) and F (CT) provide postoperative imaging, illustrating a successfully enlarged lateral recess and the resolution of compression in both the dorsal and ventral regions of the L5 nerve root. This case highlights the efficacy of the VRF technique in achieving spinal canal decompression and symptomatic relief for radiating leg pain associated with lumbar stenosis.

This composite diagnostic image displays a lateral X-ray (A) and a sagittal MRI (B) of the lumbar spine. The lateral radiograph demonstrates an anterior displacement of the L4 vertebral body relative to L5, characteristic of spondylolisthesis. There is evidence of spondylolysis, visible as a lucent defect in the pars interarticularis of the L4 vertebra. The sagittal MRI (B) provides a detailed view of the soft tissues and spinal canal, highlighting a significant disc protrusion at the L5/S1 level. This herniation causes mechanical compression of the thecal sac and likely impacts the descending L5 and S1 nerve roots. The imaging illustrates the mechanical instability of the mid-lumbar spine combined with secondary degenerative disc disease and neural foraminal/canal stenosis. These findings are clinically relevant for evaluating chronic low back pain, radiculopathy, and dermatomal sensory deficits in the lower extremities.

Anatomical diagram depicting a human dermatome map of the lumbosacral and coccygeal regions, shown from a lateral, bent-over perspective to highlight the sensory distribution along the lower extremities and posterior trunk. The illustration uses distinct shading patterns and alphanumeric labels to delineate specific cutaneous areas innervated by individual spinal nerve roots. Key segments include the lumbar dermatomes L1 through L5, sacral dermatomes S1 through S5, and the coccygeal dermatome C1. Visually, L1 covers the inguinal and hip region, L2-L3 transition down the anterior and lateral thigh, and L4-L5 extend down the lower leg to the dorsal foot. Sacral segments S1 and S2 cover the posterior leg and heel, while S3-S5 and C1 are concentrated in the perineal and gluteal regions. This medical illustration is a standard educational tool for neurological examinations, aiding in the localization of spinal nerve root compression or radiculopathy based on sensory loss patterns.