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            [0] => Large Caliber S1 mimicking a herniated disc
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    [etablissement] => Array
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            [0] => Hôpital militaire principal d'instruction de Tunis
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    [nom] => Array
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            [0] => Borchani
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    [prenom] => Array
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            [0] => Nizar
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            [0] => Nizarborchani@gmail.com
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Nom prénom / Name Surname: N.Borchani
Email: nizarborchani@gmail.com
Hôpital / Hospital: Hôpital militaire principal d'instruction

 
Nom prénom / Name Surname: S.Ghrissi
Email: ghrissisirine3@gmail.com
Hôpital / Hospital: Hôpital militaire principal d'instruction

 
Nom prénom / Name Surname: A.Abdennadher
Email: drachrafabn@gmail.com
Hôpital / Hospital: Hôpital militaire principal d'instruction

 
Nom prénom / Name Surname: K.Khelil
Email: khaledkhelil@yahoo.fr
Hôpital / Hospital: Hôpital militaire principal d'instruction

 
Nom prénom / Name Surname: K.Amri
Email: akhalil.kh@gmail.com
Hôpital / Hospital: Hôpital militaire principal d'instruction

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    [mots_cles] => Array
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            [0] => Herniated Disc;
Lumbar;

        )

    [event-id] => Array
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            [0] => 3663
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            [0] => 1
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            [0] => nizarborchani@gmail.com
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    [specialite] => Array
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            [0] => Chirurgie orthopédique et traumatologique
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    [pays] => Array
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            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introduction : 
Root emergence anomalies are rare. Radiological diagnosis is not always easy and the diagnosis is often made fortuitously intraoperatively.
Case Report:
A 44-year-old patient presenting with low back pain associated with right S1 radiculalgia for 08 months, with no improvement under analgesic treatment and well-managed rehabilitation.  Clinically, the patient had a spinal syndrome associated with a right S1 radicular syndrome with a positive Lasègue at 40 degrees, without sensitivo-motor deficits, vesico-sphincter disorders or neurogenic claudications. ODI 37/50 
Radiography showed a pinched L5 S1 space with a narrowed foramen.
 MRI showed a herniated and excluded right L5 - S1 disc, in conflict with right S1 root, which was swollen. 
Intraoperatively, after placement of pedicle screws in L5 and S1 and laminectomy, an abnormally enlarged S1 root, a slightly protruding disc, and normal emergence of the other roots were observed, notably L5 roots and left S1 root. 
A foraminotomy was performed, with release of the root path and placement of a TLIF cage.
An excellent immediate postoperative result with resolution of S1 radiculalgia.
At last follow-up (2 years), the patient was satisfied with an ODI of 47/50. 
Discussion and conclusion:
As a rare entity, the management of root emergence anomalies is not well codified. Fortunately, simple release of the nerve root tracts, i.e. foraminotomy, can improve symptomatology. Nevertheless, it is important to keep this in mind, and to be aware of the specific anatomical variants that may be encountered intraoperatively.
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