Date : 00.00.00
Name of the Patient : Abc Xyz N. Palmn / M / 75 yrs.
Referred by : Dr. Abc XyzV.Shah.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
H/O fall on 00.00.00 with paraplegia and bladder/bowel involvement since 00.00.00.
M.R.I of the dorso-lumbar 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 forward translation of the D11 over the D12 vertebra with disruption of the D11-D12 facets. Probable fracture of the right lamina of D12 is noted.
There is resultant indentation on the dorsal cord by the fractured fragment is noted posteriorly and the postero-superior aspect of the D12 vertebra anteriorly. The cord at this level appears irregular and ill-defined. The cord at the D12 level appears like a thin strand and this would be suggestive of a partial transaction. The spinal cord from the conus cauda to atleast the D9 vertebral level shows a hyperintense signal, centrally, on the T2 Weighted images (isointense to normal cord on the T1 Weighted images) and would represent cord edema/contusion in the given clinical setting.
There is wedging of the D12 vertebral body which shows an ill-defined, hypointense signal replacing the normal marrow on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. Hyperintense signal is seen in the right paraspinal soft tissue at the D12 and L1 vertebral levels on the T1 Weighted and T2 Weighted images and would represent contusion/haemorrhage. Probable fracture of the right transverse processes of D11 and D12 vertebrae is noted.
Few mid-dorsal intervertebral discs show loss of water content.
The conus medullaris terminates at the D12-L1 level.
Gross degenerative changes are seen in the lumbar spine on the screening, T1 Weighted sagittal images.
In a known C/O trauma, the MRI features are suggestive of :
1. Altered cord signal from the conus-cauda to atleast the D9 vertebral level would represent cord edema/contusion.
2. Forward translation of the D11 over the D12 vertebra and wedging with altered signal of the D12 vertebral body suggests bone bruise.
3. Probable fracture of the right lamina of D12 and the right transverse processes of D12 and L1 vertebrae with compromise of the spinal canal at the D11-D12 level.