Name of the Patient : Abc XyzAnlmn / F / 70 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with paresthesias.
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 L2 vertebral body with central wedging. This vertebral body is seen to bulge circumferentially with compression upon the thecal sac. Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the L2 vertebral body and both pedicles.
Posterior peridiscal osteophytes are noted at the L1-L2 and L2-L3 levels.
Posteriorly bulging discs are seen to narrow both neural foramina at the L4-L5 and L5-S1 levels.
There is collapse of the L3 vertebral body with anterior wedging.
The visualized dorso-lumbar vertebral bodies show areas of fatty replacement of normal marrow suggestive of osteoporosis.
The lumbar intervertebral discs show loss of water content.
The L3-L4, L4-L5 and L5-S1 facet joints show degenerative changes.
The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the 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 :
12.0 mm at L1-L2
13.0 mm at L2-L3
14.0 mm at L3-L4
10.0 mm at L4-L5
8.0 mm at L5-S1.
The cervico-dorsal spine was screened with 4 mm thick T1 Weighted sagittal images and shows areas of fatty replacement of normal marrow.
1. Collapse of the L2 vertebral body with central wedging and signal alteration as described represents a compression fracture which may be superimposed on the pathologic process (like a metastasis or small cell tumor). A biopsy from the lesion may be worthwhile.
2. Collapse of the L3 vertebral body with anterior wedging may represent a compression fracture superimposed upon an osteoporotic spine.
3. Posteriorly bulging discs at the L4-L5 and L5-S1 levels.
4. Facetal arthropathy at the L3-L4, L4-L5 and L5-S1 levels.