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Name of the Patient : Abc Xyzlmn / M / 16 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Alleged H/O RTA on 00.00.0000.
C/O paraplegia and bladder/bowel involvement since then.

EXAMINATION :

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.

OBSERVATION :

There is retroplacement of the D12 vertebra in relation to the D11 vertebra with disruption of the facet joints at the D11-D12 level.

There is anterior wedging of the D12 vertebral body which appears hypointense on the T1 Weighted images and shows a subtle hyperintense signal on the T2 Weighted images. The D11-D12 intervertebral disc is also ruptured with tear of the anterior and posterior longitudinal ligaments.

There is a fracture of the posterior elements of the D12 vertebra with disruption of the costo-vertebral joints at the D12 level, more so on the left.








There is an intermediate signal intensity soft tissue lesion in the epidural space, circumferentially over the D10 to L1 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and most likely represents an epidural hematoma. Evidence of subacute blood is noted in the posterior epidural space at the D12 and L1 vertebral levels. There is thecal sac compression over the extent of the epidural hematoma. The lower dorsal spinal cord over the D7 to D12 vertebral levels shows a hyperintense signal on the T2 Weighted images, centrally, which suggests cord contusion/edema in the given clinical setting.

Hyperintense signal on the T2 Weighted images is seen within the paraspinal soft tissues more so on the left over the D9 to D12 levels and would represent soft tissue contusions/edema.

The rest of the visualized dorso-lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The remaining facet joints are unremarkable.

The conus medullaris terminates at the L1 level.

Screening, T1 Weighted sagittal images of the lumbar spine reveals a slightly hyperintense signal of the CSF in the lumbar region which may suggest intrathecal hemorrhage.

IMPRESSION :

Retroplacement of the D12 vertebra with anterior wedging of the D12 vertebral body and fracture of the posterior elements of D12 as described, is the sequelae of previous trauma. Circumferential epidural hematoma is noted over the D10 to L1 vertebral levels with thecal sac compression. Altered signal in the dorsal spinal cord over the D7 to D12 vertebral levels suggests cord contusion/edema.



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