My Neurosurgeon appointment to go over my MRI isn’t for 2 weeks. Can you explain the following impression from my MRI of the Lumbar Spine W/WO Gadolinum Enhancement:
1. A transitional vertebra is demonstrated. For the sake of this interpretation, the transitional vertebra is designated as S1 and the vertebra above the transitional vertebra as L5.
2. There is mild hypertrophy of ligamentum flavum at L4-L5 level bilaterally.
3. There are hypertrophic changes at facet joints of L4-L5 level bilaterally.
This level shows moderate degree of stenosis of the thecal sac secondary to hypertrophic changes at facet joints, hypertrophy of ligamentum flavum and a posterior cystic lesion on the right side causing pressure over the thecal sac and right S1 nerve root.
This cystic lesion has a bilobed configuration, part of it is within the right lamina of L5 measuring about 11.05mm x 6.1mm and second component, which is interspinal, which measures about 8.7mm in diameter.
This lesion has a central non-enhancing area surrounded with a thick layer of enhancement.
It certainly does not have the appearance of a simple cyst such as a synovial cyst.
The fact that there is an interosseous component and shows considerable renal enhancement raises the possibility of an inflammatory or less likely neoplastic nature.
Biopsy and decompression of this area is advised.