Date : 00.00.00
Name of the Patient : Abc Xyzbhai lmn / M / 81 yrs.
Referred by : Dr. Abc Xyzsai / Dr. Abc Xyz Parikh.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache since 2 1/2 months.
M.R.I of the 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 collapse of the L1 vertebral body which shows hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The inferior cortical endplate appears irregular. Slight bulge of the L1 body in the pre and paravertebral soft tissues is noted, more on the right. Minimal anterior epidural extension is also noted.
There is retrolisthesis of the L3 over the L4 vertebral body.
Small posterior and bilateral far lateral disc herniations with peridiscal osteophytes are seen at the L1-L2, L3-L4, L4-L5 and L5-S1 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. Left and right postero-lateral disc bulge is noted at the L2-L3 level.
A Schmorls node is noted in the inferior aspect of the L4 vertebral body.
- 2 - Scan-00005
Anterior disc herniations are seen at the L2-L3 and L3-L4 levels with larger peridiscal osteophytes. The lumbar intervertebral discs show loss of water content.
The lumbar facet joints show degenerative changes.
The rest of the lumbar vertebral bodies reveal spotty fatty marrow changes suggesting osteoporosis.
The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S1 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
6.0 mm at L1-L2
16.0 mm at L2-L3
13.0 mm at L3-L4
12.0 mm at L4-L5
12.0 mm at L5-S1.
The dorsal and the cervico-dorsal spines were screened with 4 mm thick T1 Weighted sagittal images which reveal fatty marrow changes in the vertebrae.
The MRI features are suggestive of :
1. Collapse of the L1 vertebral body with altered signal as described is most probably due to trauma superimposed on an osteoporotic spine. A neoplastic etiology should be ruled out, though less likely.
- 3 - Scan-00005
2. Small posterior and bilateral far lateral disc herniations, with peridiscal osteophytes at the L1-L2, L3-L4, L4-L5 and the L5-S1 levels.
3. Left and right postero-lateral disc bulges at the L2-L3 level.
4. Fatty marrow changes in the visualized cervical, dorsal and rest of the lumbar vertebrae suggests osteoporotic changes.