Demographics:
77 years old, Male
Indication:
Bilateral lower extremity weakness and pain
Findings
- Lumbarization of the S1 vertebral body
- 5 mm T2/STIR hyperintense extradural structure on the right at the level of L1-L2 extending medially from the facet joint, which results in severe spinal canal stenosis and mass effect on the conus
- Increased T2/STIR signal centrally in the conus at the level of L1-L2
- Multilevel broad-based disc bulges, facet hypertrophy, ligamentum flavum thickening, and epidural lipomatosis contribute to advanced spinal canal stenosis at L3-L4 and L4-L5, moderate spinal canal stenosis at L2-L3 and L5-S1, and varying degrees of multilevel neural foraminal stenosis, which is severe on the right at L1-L2, on the right at L4-L5, and bilaterally at L5-S1
- Trace anterolisthesis at L5-S1
- Distended urinary bladder
Diagnosis
Synovial cyst with cord compression
Sample Report
Transitional lumbosacral anatomy with lumbarization of the S1 vertebral body.
5 mm synovial cyst on the right at L1-L2 which severely narrows the spinal canal and exerts mass effect on the conus. T2/STIR signal hyperintensity in the conus at this level is concerning for edema.
Multilevel broad-based disc bulges, facet hypertrophy, ligamentum flavum thickening, and epidural lipomatosis contribute to advanced spinal canal stenosis at L3-L4 and L4-L5, moderate spinal canal stenosis at L2-L3 and L5-S1, and varying degrees of multilevel neural foraminal stenosis, which is severe on the right at L1-L2, on the right at L4-L5, and bilaterally at L5-S1.
Discussion