Reporting a lumbar spine MRI - disc extrusion

Lumbar spine MRI is probably one of the most commonly performed MRI exams in radiology. This is because back pain is extraordinarily common and increases with age. As a result, we do a number of studies to try to determine what is the cause of the back pain.

There are a number of things that can cause back pain. Discs can bulge (and protrude, or extrude), facets can degenerate, and endplates can erode. All of these can cause pain. Unfortunately, the nerves of the spinal cord and extremities pass through this region and their compression can cause a lot of pain.

Today we'll do things a little differently. I'm going to show you an example case on the radiology PACS of a young patient with back pain radiating down the right leg. I'll show you how I set up the study to view and systematically how I look at it. In addition, I'll show you how our reports are formatted and how you can as well.

This patient has a disc extrusion at L4-L5 which is pressing on the exiting nerve root in the lateral recess (or subarticular zone). This is just one of the many reasons to have radicular pain.

The level of this video is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in spine imaging. General medicine practitioners will see plenty of back pain and may wonder what we are thinking. Neurosurgeons and orthopedic surgeons can learn more to strengthen their practice as well.

[queenpower]

If I knew about your program before knowing that I want to go into radiology. I would have worked very hard to obtain a spot in your residency program. Again, this is amazing!

[makarand]

Is sequestration happened in L4 L5 ? What recommanded in this case either surgery or conservatory treatment.

[immane]

Hi, it's been a lo, g time, hope you are fine ? Can you please do a video on your search pattern for cervical MRI and step bey step reporting ? You can't imagine the impact of your videos on my confidence, I can't thank you enough Your residents are so lucky !!!!

[dr.kushagramittal]

Where to measure the spinal canal diameter, at the midvertebral level or at the disk level (where the actual stenosis happens)?

[UneSteakFrites]

Why describe a grade of the disc bulge at L3-L4 but not L2-L3? What is the difference between a small disc bulge and a mild disc bulge?

[sudeepsinghawal]

Where can i get that MRI reporting template?