Date : 00.00.00
Name of the Patient : Abc Xyz Plmn / M / 50 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
H/O anterior approach with discectomy at the C2-C3 and C3-C4 levels on 00.00.00.
C/O weakness of BUE and BLE with bladder/bowel involvement since then.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
There are large apparent disc herniations at the C2-C3 and C3-C4 levels with anterior compression of the cord. The spinal cord at these levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to the normal cord on the T1 Weighted images suggestive of cord edema/ischemia/myelomalacia. Heterogeneously hypointense areas in the prediscal region at the C2-C3 level may represent bone grafts.
Small posterior disc herniations at the C5-C6 and C6-C7 levels and a postero-central disc protrusion at the C4-C5 level with anterior indentation of the thecal sac are noted. The lower cervical intervertebral discs show loss of water content.
Hypointense areas are seen within the C2 and C3 vertebral bodies on the T1 Weighted images which are seen to turn hyperintense on the T2 Weighted images and would represent post-operative edema/bruise.
The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
The MRI features are suggestive of :
1. Post-operative status with edema/bruise in the C2 and C3 vertebral bodies as described.
2. Large apparent disc herniations at the C2-C3 and C3-C4 levels with cord edema/ischemia/myelomalacia at these levels.
3. Small posterior disc herniations at the C5-C6 and C6-C7 levels.
4. A postero-central disc protrusion at the C4-C5 level.