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.


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