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- MRI LUMBOSACRAL SPINE
- DIAGNOSIS
- TECHNIQUE:
- T1-T2 sag, axial and coronal and MR myelogram were done.
- FINDINGS :
- There is straightening of the usual lumbosacral curvature presumably due to paraspinal muscle spasm.
- The usual alignment of the spine is maintained.
- Anterior marginal osteophytes are seen at the superior and inferior borders of L3 - L5.
- Schmorl’s nodes are seen on the inferior endplate of L4 and the superior and inferior endplates of L5.
- The remaining vertebral bodies and appendages show normal signal intensities.
- Changes of disc desiccation are seen at the L2/3 to L5/S1 levels characterized by reduction of the usual high T2 signal intensity and reduction in disc height.
- Disc bulges and are seen at the L2/3 to L5/S1 levels, causing indentation of the anterior theca.
- At the L2/3 level, the disc bulge is worsened by a central and right subarticular disc herniation. Bilateral ligamentum flavum hypertrophy and facetal joint effusions are seen.
- These cause relative spinal canal stenosis, compression of the cauda equina and cause the disc to abut on the exiting nerve roots
- At the L3/4 and L4/5 levels, the disc bulge is worsened by bilateral ligamentum flavum hypertrophy and facetal arthropathy.
- Compression of the traversing nerve roots seen at the L3/4 and L4/5 levels, worse on the left and at the L4/5 level.
- Relative spinal canal stenosis seen at the L4/5 level
- At the L5/S1 level, the disc bulge is aggravated by bilateral facetal arthropathy and ligamentum flavum hypertrophy.
- These cause compression of the traversing nerve roots, worse on the left.
- The remaining nerve roots are normal.
- No intradural / intramedullary lesions.
- The conus medullaris and cauda equina are normal.
- Pre and para spinal soft tissues are normal.
- IMPRESSION
- Lumbar spondylosis
- Multilevel degenerative disc disease- Disc bulges and herniations at the L2/3 to L5/S1 levels, causing:
- Relative spinal canal stenosis at the L2/3 and L4/5 levels,
- Compression of the cauda equina at the L2/3 level and
- Compression of the traversing nerve roots at the L2/3 to L5/S1 levels, worse on the left.
- CORRELATE CLINICALLY AND FOLLOW UP.
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