USA, CAN     772-600-7827

Case 16- 45yo/M with “deep” lower back discomfort.

45 yo/M patient presents with “deep” LBP.

No prior trauma, surgeries,  carcinoma  or corticosteroid/opioid regimen reported.

What do you see?

Lateral lumbar spine view

The sagittal dimension of the abdominal aorta measures 4.4 cm. well beyond the accepted normal measurement of 3-3.5 cm. (1)
The radiodensity seen superimposed the VB is in soft tissue.

The transverse dimension of the abdominal aorta measures 4. 4 cm.  (N=3.0-3.5 cm). <sub> (1)</sub>

The radiodensity superimposed on the L3 VB is within soft tissue as are the densities anterior to the upper lumbar VB. 

A CT scan of the abdomen was ordered.


  • most common cause of death in Western world.
  • atherosclerotic etiology is most common.
  • US can be used for AAA screening & following small dilations.
  • CT angiography is considered gold standard.
  • > 5.0 mm enlargement within 6 month span warrants intervention. >sub>(3)</sub>

A 3D reformatted  model of an abdominal aortic aneurysm is in its common infra-renal location. <sub> (2)</sub>

DISCUSSION: The mass effect of the OPLL seen on the axial CT image may causes stages of cord damage described by seen above. The cases of OPLL that occupy 30-60% of the cross-sectional diameter are more likely to show myelopathy. Laterally deviated OPLL masses have a higher risk of myelopathy than those at the midline (5)


  1. Essentials of Skeletal Radiology, Yochum & Rowe 2nd. Ed. p. 1309
  2. From the case rID: 8190

Will another DC benefit from this case?