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CSF cytology and HIV serology were both negative. EMG, however, confirmed the clinical findings of polyradiculopathy. T1W and T2W MRI of the lumbar spine demonstrated diffuse thickening of the nerve roots of the cauda equina, which enhanced following intravenous gadolinium administration (Figs. 1 and 2). No parenchymal involvement was seen.
The L4 root exits the spine at the L4 vertebral level. This is part of the lower lumbar spine and is one of the most common regions to experience degenerative disc disease and herniated discs, as well as general spinal degeneration, including osteoarthritis.he L4 spinal nerve root joins up with the L5, S1, S2 and S3 nerves to create the sciatic nerve. This is the largest nerve in the body and has branches which descend down both legs.