Congenital absence of L4–L5 articular facet joint

A 34-year-old high school teacher and dance passionate presented to our outpatient clinic for severe low back pain. His medical history was uneventful, in particular, he had no history of trauma or lumbar blockage. He complained of 4 weeks of severe pain in the back, of which the first was spent mostly at home lying in bed. Lumbar magnetic resonance imaging was prescribed, and the patient was referred to a neurosurgeon. Painkillers and anti-inflammatory drugs had little effect. Neurological examination results were normal, and pain was paravertebral right-sided and corresponding to the L4–L5 level.