MRI of lumbar spine
History: Inability to stand for prolonged periods of time (more than 5 - 10 minutes) without falling and paralysis of lower extremeties.
Technique:Sagittal and axial views, T1 & T2 weighted senquences to include flexion and extension with axial loading in the neutral sitting postion.
Findings: There is scoliosis convextivity to the left and the lower segment.
To the right and the uper segment.
There is depression of the superior end plate of L2 of approximately 15-20% with no marrow changes suggestion this is old.
The axial views obtained through the canal at
L1-2 demonstrate a desiccated disc. There is a central broadbased annular buldge with mild up/down foraminal compromise bi-laterally. No significant canal stenosis.
L2-3 there is desiccated disc. There is a broadbased 1-2mm annular buldge, which creates mild u/down foraminal compromise bilaterally somewhat moreso to the right. No significan canal stenosis.
L3-4 There is desiccated disc. There is mild loss of disc space height. There is a broadbased centeral 2mm protrusion. This creates mild canal and mild up.down foraminal compromise bilaterally with mild degenerative facet changes as well. There is also mild lateral recessed stenosis on the right.
L4-5 There is a desiccated disc. Loss of disc space height. There is a shallow 2mm protruding disc extending into the right foraminal. MIld up/down right foraminal compromise. MIld degenerative facet changes.
L5-S1 There is a desiccated disc. There is loss of disc space height. There is a 1-2mm broadbased annular buldge. This creates mild up/down foraminal compromise bilaterally.
IMpression
1 Background of scoleosis
2 Annular buldge at L5-S1 without significant canal stenosis. Very mild up/down foraminal compromise bilaterally. This area is stable with flexion and extension. Suttle asymunetric protrusion of disc within the foramen to the right at L4-5. This results in slight increase foraminal compromise on extension, decompressing with flexion. Question more focal left L4 and/or left L5 symptoms.
3. Central mild buldge at L3-4 without significant canal and/or forminal compromise, stable with flexion with extension
4. Very subtle asymunetric protusion of disc at L2-3 to the right, once again stable with flexion and extension.
5. Old depression of superior end plate of L2. NO evidence for segmental instability.