MRI EXAMINATION OF THE LUMBAR SPINE WITHOUT CONTRAST

MRI EXAMINATION OF THE LUMBAR SPINE WITHOUT CONTRAST

INDICATION FOR STUDY:         Lumbago.  Bilateral S1 radiculopathy, right worse than the left.  Possible neurogenic claudication.  Lumbar stenosis.  Patient is claustrophobic and requested Open MRI.

FINDINGS:               Sagittal T1 and T2 and axial T1 and T2 weighted images were obtained on the Open MRI.  The axial images were obtained in a block fashion as previously requested.  The vertebral bodies are in relatively good alignment.  The patient is slightly rotated.  There is disc space loss at L5-S1.  There is desiccation of the disc especially at L3-L4 and L4-L5, but no significant disc space loss.  The conus shows no gross abnormality.  There is question of the possibility of stenosis in the lower thoracic spine at the T11-T12 level slightly, but it is not optimally seen and if there is any further clinical concern, would recommend dedicated evaluation of the thoracic spine if necessary.  This is only seen at the top edge of the sagittal images.  The examination is slightly limited given the patient’s body habitus.

At the level of T12-L1, there is no significant disc herniation, central canal stenosis, or neuroforaminal narrowing.

At the level of L1-L2, there is no significant disc herniation, central canal stenosis, or neuroforaminal narrowing.

At the level of L2-L3, there are mild degenerative changes of the facet joints and ligamentum flavum hypertrophy.  There is no significant disc herniation.  These changes are causing indentation on the anterior thecal sac and mild central canal stenosis.  There is no significant neuroforaminal narrowing.

At the level of L3-L4, there are slight degenerative changes of the facet joints and ligamentum flavum hypertrophy.  There is slight indentation on the anterior thecal sac.  These changes overall are causing mild central canal stenosis.  There is somewhat congenitally small canal.  There is no significant neuroforaminal narrowing.

At the level of L4-L5, there are degenerative changes of the facet joints.  There is diffuse disc bulge.  There is slight ligamentum flavum hypertrophy.  These changes overall are causing moderate central canal stenosis and indentation on the exiting nerve roots bilaterally slightly, but no significant impingement.  There is minimal offset secondary to degenerative changes of the facet joints at this level.

At the L5-S1 level, there is disc space loss.  There are degenerative changes of the facet joints.  There is indentation on the anterior thecal sac.  There does not appear to be significant central canal stenosis, but there is indentation on the nerve roots within the thecal sac.  There is also indentation on the exiting nerve roots bilaterally secondary to degenerative changes predominantly, but no significant impingement in the neuroforaminal regions.  If there is any further concern, would recommend further evaluation as clinically necessary.

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