Lumbar spinal canal stenosis

Case contributed by Dr Bruno Di Muzio

Presentation

Chronic sciatica.

Patient Data

Age: 60-year-old
Gender: Male

MRI Lumbar spine

Modality: MRI

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. 

Modality: Annotated image

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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Case Information

rID: 40590
Case created: 27th Oct 2015
Last edited: 22nd Apr 2017
System: Spine
Inclusion in quiz mode: Included

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