2023 ARRS ANNUAL MEETING - ABSTRACTS

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E2492. Algebra, Geometry, and Baseball: An Approach to MR Spine
Authors
  1. Chris Huebner; Tulane Hospital
  2. Jagan Gupta; Tulane Hospital
  3. Neel Gupta; Tulane Hospital
Background
MR spine can be a challenging for new radiology residents as the evaluation of radiculopathy is often multifactorial and relatively subjective compared to other types of studies. Many factors such as ligamentum flavum hypertrophy, epidural lipomatosis, disc pathology, and osteophytosis can all contribute to symptomatic cord or nerve compression to some degree. In this study, we propose an approach to evaluating the lumbar spine using the degenerative and/or hypertrophic changes (x variables) and the resultant effect on the spinal canal, neural foramina, and lateral recesses (y variables).

Educational Goals / Teaching Points
Discuss degenerative/hypertrophic factors that can contribute to spinal cord symptomatology, including how to describe these changes and create a narrative to convey how these changes (x variables) can cause symptomatic pathologies (y variables). Describe exiting and traversing nerve roots and how they can be affected differently based on the x variables. Propose a fun and comprehensive method for describing level by level spinal pathology.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
MR lumbar spine sequences, intervertebral discs, ligamentum flavum, epidural lipomatosis, retro/anterolisthesis, lateral recesses, and central spinal canal.

Conclusion
MR spine can be challenging for new radiology residents as the evaluation of radiculopathy is often multifactorial and relatively subjective compared to other types of studies. Having a consistent method of evaluating degenerative/hypertrophic changes and their subsequent pathology is key to interpreting spinal canal and neural foraminal stenosis. Thinking in terms of how the x variables affect y variables can lead to a better understanding of degenerative spinal pathology.