T1 pre-gad | T2 FSE | T2 FSE |
Patients typically present with symptoms of pseudoclaudication where they have lower extremity pain with walking which tends to be relieved with leaning forward. The classic way to differentiate pseudoclaudication from vascular claudication is by the clinical story. The spinal stenosis patient describes relief of symptoms when going up stairs since most people tend to bend forward when climbing. On MR, the severity of the central canal narrowing is best evaluated on the T2 axials. Abnormal intradural gadolinium enhancement has been described above severely stenotic levels in the lumbar spine. This is thought to be due to obstructed veins and break down of the blood nerve barrier due to inflammation. This patient underwent a decompressive laminectomy from L3 to L5 with medial facetectomy on the right L4-5 with removal of the focal disk protrusion. Related Cases
Jinkins JR. Gd-DTPA enhanced MR of the lumbar spinal canal in patients with claudication. J Comput Assist Tomogr, Jul-Aug 1993; 17(4):p555-62.
Synovial cyst | Synovial cyst | Lateral HNP |