Presentation
Chronic sciatica.
Patient Data
Alignment of the lumbosacral spine is normal with preservation of body heights, promient anterior osteophytosis.
L3/4: Disc bulge does not significantly further narrow the vertebral canal, bur promotes mild effacement of the lateral recesses. L4/5: Disc bulge and ligamentum flavum hypertrophy contribute to a severe narrowing of the vertebral canal and effacement of the lateral recesses. Moderate narrowing of both intervertebral foramina.
The conus terminates at the inferior aspect of L1 and has a normal appearance.
L4/5: Disc bulge (green) and ligamentum flavum hypertrophy (yellow) contribute to a severe narrowing of the vertebral canal and effacement of the lateral recesses. Moderate narrowing of both intervertebral foramina.
Case Discussion
This case demonstrates a typical acquired lumbar canal stenosis in an elderly patient, with both disc bulging and ligamentum flavum hypertrophy playing together to narrow the canal at the level of L4/5. Cases such this one are the most frequent indication for lumbar surgery in the elderly.
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