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Back pain radiating down the leg past the knee — sciatica; L4-L5 prolapse; physiotherapy. Disc prolapse (L4–L5, L5–S1 commonest — posterolateral — sciatica — leg > back pain, dermatomal: treat — NSAIDs, physiotherapy, rest — 90% resolve; surgery — deficit, cauda equina): cauda equina (saddle anesthesia, retention, bilateral — emergency decompression <24h): spinal injuries (cervical — hangman's, Jefferson — quadriplegia; thoracolumbar — wedge/burst — paraplegia: assume — collar, log-roll; MRI — cord; treat — decompress + stabilize — steroids controversial). Red flags — trauma, cancer history, fever, weight loss — image. The saddle numbness is cauda equina — operate tonight.