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.

See this and other videos on our Youtube channel.