MRI OF THE LUMBAR SPINE WITHOUT CONTRAST
DATE OF STUDY: MM/DD/YYYY
INDICATION FOR STUDY:
Everything from waist down hurts, low back pain, and right knee pain.
TECHNIQUE AND FINDINGS:
Sagittal and axial images were obtained. The extra large flex coil was used for the spine examination. Detail is slightly limited due to the patient’s large body habitus. There is a comparison study from MM/DD/YYYY.
Sagittal and axial images were obtained. The conus is normal in location and signal intensity. The vertebral bodies are in good alignment. The marrow signal within the bony structures is unremarkable. There is disc desiccation at L3-4, L4-5, and L5-S1. On the sagittal images, there is suggestion of some bulging disc at T9-10 and T10-11 in the central to left paramedian location. This area was not included on the prior lumbar spine.
At L5-S1, there is an increase in the narrowing of the spinal canal when compared with the prior study. There are posterior facet degenerative changes and a circumferential disc bulge. The bulge appears to have a left paramedian component that does extend centrally superior to the disc space. The spinal canal is markedly narrowed when compared with the prior study.
At L4-5, there is a circumferential disc bulge and posterior facet degenerative changes. The neural foramina are narrowed bilaterally, right more than left. A component of the disc appears to be more right sided filling, right neural foramen, on both the sagittal and axial images. The L4-5 level appears to be slightly worse than on the prior study as well.
At L3-4, there is a circumferential disc bulge that has a prominent right lateral foraminal component. This right lateral foraminal component is new compared to the prior study versus increased. This most likely affects that exiting right nerve root.
IMPRESSION:
1. The L5-S1 level is markedly worse than on the prior study with some stenosis. This is due to a combination of disc bulge, posterior facet degenerative changes, as well as component of protrusion that is left paramedian and extends superior to the disc space in the central location. Anteroposterior diameter of the spinal canal is narrowed. This is more striking on the T2 axial images than it is on the T1 weighted axial images. This is seen on the sagittal sequences as well.
2. L4-5 level is slightly worse with a component of the disc extending into the right neural foramen when compared with the prior study. There is a persistent disc bulge and posterior facet degenerative changes that were seen on the prior study. That exiting right nerve root may well be affected by the protruding disc.
3. At L3-4, there is a new or increased component of the protruding disc in the right neural foramen at and just above the disc space. This is a quite prominent protruding right lateral component to the disc. Anteroposterior diameter of the spinal canal is slightly narrowed due to posterior facet degenerative changes and the disc bulge.
