PMC5223753_01
Initial (A) T2-weighted and (B) T1-weighted magnetic resonance images demonstrating central disc protrusion from an underlying bulging disc with facet osteoarthritic changes and mild central canal stenosis at the L4-5 spinal segment.
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Initial L-spine magnetic resonance imaging (MRI) showed left central disc herniation at the L4-5 level (Fig. 1), and the patient received IDET at a local hospital.
A : Computed tomography image shows a smooth, round-shaped, multilobulated bony defect at the L4-5 spinal segment with sclerotic margins. B : T2-weighted and (C) T1-weighted magnetic resonance (MR) images 3 months after intradiscal electrothermal therapy at the L4-5 intervertebral disc. The L4-5 intervertebral disc and L4 and L5 vertebral body lesion shows a marked increase in size with an increased signal at the L4-5 intervertebral disc. Note the contour bulging in the epidural space at the L4-5 spinal segment. The MR image shows diffuse marrow edema at the L4-5 spinal segment.
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Computed tomography (CT) showed a smooth, round-shaped, multilobulated bony defect at the L4-5 spinal segment with a sclerotic margin (Fig. 2A). In addition, contour bulging of the epidural space was present at the L4-5 intervertebral disc (Fig. 2B). T1-weighted MRI showed diffuse marrow edema at the L4-5 intervertebral disc (Fig. 2C).
A : Computed tomography obtained 12 months after the patient's intradiscal electrothermal therapy (IDET) shows a bony defect decrease in size of the L4-5 lesion. B : Follow-up T2-weighted and (C) T1-weighted magnetic resonance (MR) images 12 months after IDET showing improvement of signal change at the L4-5 intervertebral disc and marrow edema at the L4 and L5 vertebral bodies.
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Repeat CT and MRI 12 months after IDET showed a bony defect at L4-5 and a decrease in size of the L4-5 intervertebral disc lesion (Fig. 3).