Lower back pain and bladder dysfunction
A 36 year old man presented with progressive low back pain and bladder dysfunction. He had had periods of non-specific back pain for more than a year. In the past two weeks the pain had got worse, radiating from the left dorsolateral thigh to the lateral site of his left foot. For three days he had had difficulties initiating micturation, and the flow had weakened. He felt numb sensations in the left scrotum, the perineal region, and on the lateral site of the left foot. He also noticed muscle weakness in the left foot. He had no history of trauma or recent disease.
General physical examination indicated a healthy young man. Neurological examination showed paralysis of the left foot extensors, motor weakness of left foot flexors (grade 2-3), and sensory deficits from the medial leg to the dorsal lateral foot. The patellar reflexes were vivid on both sides (left more