Name of the Patient : Abc Xyzbai Blmn / F / 75 yrs.
Referred by : Dr. Abc Xyzvale.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with paresthesias and bladder involvement.
M.R.I of the lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
There is central wedging of the L1 vertebral body with replacement of the normal marrow of the L1 vertebra by hypointense areas on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the T2 Weighted images. There is circumferential bulging of the L1 vertebral body. The postero-superior portion of the L1 vertebral body is seen to cause mild indentation upon the spinal cord. The cord at the D12 and L1 vertebral levels shows a hyperintense signal on the T2 Weighted images and which is isointense to cord on the T1 Weighted images and which may represent cord edema/ischemia.
There are diffuse posterior disc herniations at the L4-L5 and L5-S1 levels and bilateral far lateral disc bulges at the L2-L3 level. The lumbar intervertebral discs show loss of water content.
Fatty changes are noted in the lumbar vertebral bodies with a hemangioma (hyperintense on all the pulse sequences) in the L2 vertebral body.
The conus medullaris terminates at the L2 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 :
13.0 mm at D12-L1
16.0 mm at L1-L2
11.0 mm at L2-L3
8.0 mm at L3-L4
4.0 mm at L4-L5
6.0 mm at L5-S1.
The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images which shows hemangioma (hyperintense) in the D6 vertebral body. No other significant abnormality is detected.
1. Central wedging and altered signal of the L1 vertebral body with cord indentation and cord edema/ischemia over the D12 and L1 vertebral levels probably represents fracture superimposed on an osteoporotic spine. The possibility of a neoplastic process cannot be entirely ruled out though less likely.
2. Fatty changes in the lumbar vertebral bodies most likely represents osteoporotic changes.
3. Diffuse posterior disc herniations at the L4-L5 and L5-S1 levels.