Presentation
Back pain and sciatica.
Patient Data
Wedge shaped body of T12 vertebra with preserved homogeneous bone marrow that shows mild increased signal on T1 and T2. Mild protrusion of posterior inferior corner indenting anterior subarachnoid space.
Diffuse spondylodegenerative changes and facet joint arthropathy with multiple diffuse posterior disc bulges on L2-3 till L5-S1 levels. Ligamentum flavum hypertrophy is noted on L2-3 and L3-4 levels. These changes result in spinal canal stenosis, mild on L4-5 and L5-S1 levels, moderate on L2-3 level and severe on L3-4 level. Redundant cauda equina nerve roots are noted. Prominent small serpiginous vessels through cauda equina reflecting venous congestion.
Minimal spondylolisthesis of L5 over S1 vertebra.
Case Discussion
This case shows multiple causes of secondary spinal canal stenosis; spondylodegenrative changes, disc herniation, ligamentum flavum hypertrophy, facet joint arthropathy and bony projection from vertebral fracture.
Redundant cauda equina nerve roots refers to the serpiginous or coiled appearance of cauda equina which occurs at levels of moderate to severe spinal canal stenosis.
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