Date : 00.00.00
Name of the Patient : Abc Xyzn Bholmn / F / 11 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Dorso-lumbo-sacral Spine.
CLINICAL PROFILE :
C/O kyphoscoliosis for surgery. Patient walks with a limp.
M.R.I of the dorso-lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
There is a scoliotic deformity of the dorso-lumbar spine with convexity to the right.
There is a congenital block L2/L3 vertebra with a hypoplastic L2-L3 disc. Segmentation anomalies (butterfly vertebrae) are noted at the D10 and D11 levels. Spina bifida is noted at the L3, L2, D12 and probably D11 levels. There is anti-clockwise rotational anomalies of the dorso-lumbar vertebrae over the D8 to L4 levels and slight clockwise rotational anomalies of the upper dorsal vertebrae. The aorta and the IVC in the dorso-lumbar region are placed more so in the midline or slightly to the left of the midline (with the vertebrae rotated in the anti-clockwise direction).
There is evidence of two hemicords within a single thecal sac extending over approximately the D11 to L2 vertebral levels. It is difficult to distinguish deep midline clefts and hemicords over the D7 to D10 vertebral levels. No obvious bony bar or fibrous band is noted. The conus medullaris terminates at about the L3 vertebral level. No obvious intradural lipoma is noted on this study.
A syrinx is noted within the upper dorsal spinal cord over about the D4 to D6 vertebral levels.
Screening, T1 Weighted sagittal images of the cervical spine do not reveal any cranio-vertebral anomaly.
The visualized dorso-lumbo-sacral vertebral bodies reveal normal signal intensity. Small posterior peridiscal osteophytes are noted at the D9-D10 and D10-D11 levels.
The visualized pre and paravertebral soft tissues are unremarkable.
The MRI features suggest scoliotic deformity of the dorso-lumbar spine with segmentation and rotational anomaly of the dorso-lumbar vertebrae. Two hemicords is noted over the D11 to L2 vertebral levels without obvious bony/fibrous bar. A syrinx is noted in the dorsal spinal cord over the D4 to D6 vertebral levels and probably extends into the hemicords at the D7 and D8 vertebral levels.
It is difficult to distinguish deep midline clefts and hemicords over the D7 to D10 vertebral levels.