MRI Lumber Spine Format

MRI OF LUMBAR SPINE

Protocol :

A plain MRI of the lumbar spine was performed, using routine turbo spine sequences in multiple axial, coronal and sagittal planes using the spine coil. The sequences used were axial T1W and T2W TSE, coronal T2W TSE, sagittal T1W and T2W TSE along with fat supressed T2 screening of the SI joints in axial plane.

Findings :

There is mild straightening of the lumbar spine with normal posterior alignment of teh vertebral bodies. Normal adult marrow signals of the lumbar vertebrae are noted. The posterior elements are normal. Anterior and lateral marginal osteophytes are seen in the lower lumbar vertebrae.

There is mild reduction of the height of the L3-4 lumbar disc with decreased and altered signal intensity of the annulus fibrosus and nucleus pulposus on T2 images of L3-4 & L4-5 suggesting early disc dessication.

There is evidence of postero-central and right para-central disc bulge at the level of L4-5  with minimal thecal indentation and impingement of ipsilateral exiting nerve root.

There is a  circumferential  bulge at L5-S1 level without any thecal sac or nerve root compression.

The spinal cord ends at L1. Conus medullaris appears normal. The paravertebral soft tissues are normal. Facet joints are normal with normal signal intensity of the joint spaces. Ligamentum flavum are normal in size without any evidence of altered signal intensity.

Sagittal bony canal dimensions of the lumbar spine are within normal limits.

Axial screening of the SI joints reveal no evidence of altered signal intensity or joint space irregularity.

IMPRESSION : PLAIN MRI OF THE LUMBAR SPINE REVEALS -

1. CENTRAL AND  RIGHT PARA-CENTRAL DISC BULGE AT L4-5 LEVEL INDENTING THE THECAL SAC AND ABUTTING THE IPSILATERAL EXITING NERVE ROOT.

2. CIRCUMFERENTIAL DISC BULGE AT  L5-S1 LEVEL WITHOUT NERVE SLEEVE COMPRESSION.

HERNIATION

MRI OF LUMBAR SPINE

Plain MRI of the lumbar spine was performed in axial T1 & T2, Coronal STIR, Sagittal T1 & T2 sequence and coronal fat supressed sequence of the SI joints. Sagittal T2 screening of the whole spine was also performed.

There is loss of normal lumbar lordosis. The posterior alignment of lumbar spine is

maintained. Marrow signals of the lumbar vertebrae are of normal adult type.

Minimal facetal degenerations are seen involving multiple lumbar vertebra.

The vertical heights of the lumbar intervertebral discs are maintained.

The signal intensities of the nucleus pulposus and annulus fibrosus of the lumbar intervertebral disc are lost at

L5-S1-suggesting disc dessication.

There is postero-central extrusion of L5-S1 disc with indentation of the thecal sac and mild compression of the left exiting nerve root.There is minimal inferior migration of the extruded disc on the left side.

Mild diffuse disc bulge is seen at L4-5 level with no evidence of nerve sleeve compression.

Ligamentum flavum is unremarkable. No evidence of altered signal intensities are seen in the ALL & PLL.

The paravertebral soft tissues are normal.

Spinal Cord ends at D12-L1.Conus medullaris appears normal.

Both the SI joints are normal in signal intensities.

Sagittal T2 screening of the whole spine does not reveal any remarkable lesion.

IMPRESSION : MRI OF THE LUMBAR SPINE REVEALS-

1) POSTERO-CENTRAL HERNIATION OF THE L5-S1 DISC WITH MINIMAL INFERIOR MIGRATION

    ALONG WITH COMPRESSION OF THE TRAVERSING NERVE ROOT (LEFT).

2) MILD DIFFUSE DISC BULGE AT L4-5 LEVEL WITH NO NERVE SLEEVE COMPRESSION.

3) MILD FACETAL DEGENERATIONS AT MULTIPLE LEVELS.

MRI OF LUMBAR SPINE

A plain and contrast enhanced MRI of the lumbar spine was performed, using routine turbo spine sequences in multiple axial, coronal and sagittal planes using the spine coil.

The sequences used were MR Myelogram is sagittal and coronal planes, axial T1W TSE, axial T2W TSE, Coronal STIR, T1W TSE sagittal, T2W TSE sagittal along with fat supressed T2 screening of the SI joints in axial plane.

There is mild loss of normal lumbar lordosis. The alignment of lumbar spine is maintained. Anterior and lateral marginal osteophytes are seen at multiple lumbar levels.

Type II end-plate change is seen in the adjoining L4 and L5 vertebrae with schroml's node at inferior end-plate of L4 vertebral body. Marrow signals of the lumbar vertebrae are of normal adult type. Incidentally, vertebral body haemangioma of D12 vertebra is noted.

Decrease in the vertical height of L4-5 disc is noted with loss of normal T2 signal intensities - suggesting disc dessication. Disc dessication is also noted at L2-3, L3-4 and L5-S1 levels. Small focal hyperintense lesion is noted in the posterior aspect of L3-4, suggesting posterior annular tear.

Diffuse disc bulge with left paramedian herniation is noted at L3-4 causing compression of  ipsilateral traversing L4 nerve root.Circumferential bulging with posterior and foraminal protrusion of L4-5 disc is also noted causing  foraminal encroacment, compressing traversing and impinging exiting nerve roots bilaterally. Mild bulging with central protrusion is seen at L5-S1 disc without significant thecal sac or nerve root compression.

There is ligamentum flavum hypertrophy and early facetal arthropathy at L3-4 and L4-5 levels, compounded with disc changes resulting corresponding secondary canal stenosis.

Spinal Cord ends at L1.Conus medullaris appears normal. The paravertebral soft tissues are normal.

IMPRESSION : -

1) Diffuse bulging and left paracentral herniation of L3-4 disc with posterior annular tear causing foraminal encroachment and compression of ipsilateral traversing nerve root.

2) Diffuse disc bulge at L4-5 level with central and foraminal protrusion causing compression / impingment of traversing and exiting nerve roots bilaterally.

3) Evidence of degenerative spinal changes as mentioned.

MRI OF LUMBAR SPINE:

Protocol :

A plain MRI of the lumbar spine was performed, using routine turbo spine sequences in multiple axial, coronal and sagittal planes using the spine coil. The sequences used were axial T1W and T2W TSE, coronal T2W TSE, sagittal T1W and T2W TSE along with fat supressed T2 screening of the SI joints in axial plane.

Findings :

There is mild straightening of the lumbar spine with normal posterior alignment of the vertebral bodies. Marginal osteophytes are noted. Vertebral bodies and posterior elements show normal height and signal intensity.

There is evidence mild circumferential disc bulges at the level of L4-5  and L5-S1 levels without remarkable thecal sac or nerve sleeve compression.

The spinal cord ends at D12- L1. Conus medullaris appears normal. The paravertebral soft tissues are normal.

Facet joints show mild to moderate degeneration at L3-4, L4-5 and L5-S1 levels.

Ligamentum flavum are normal in size without any evidence of altered signal intensity.

Sagittal bony canal dimensions of the lumbar spine are within normal limits.

Axial screening of the SI joints reveal no evidence of altered signal intensity or joint space irregularity.

Slight malrotattion of left kidney is noted.

IMPRESSION : PLAIN MRI OF THE LUMBAR SPINE  REVEALS -

1. MILD DISC BULGES AT L4-5 AND L5-S1 LEVELS WITHOUT REMARKABLE THECAL SAC OR NERVE SLEEVE COMPRESSION.

2. DEGENERATIVE FACET JOINT CHANGES AT MULTIPLE LEVELS.

The images pertaining to this study have been studied and the report has been vetted on Teleradiology by