Herniation vs disc protrusion — definitions?

Fardon/Milette (2014) standard: bulging = wide base (> 25% of circumference); protrusion = base ≥ length; extrusion = length > base; sequestration = disconnected fragment.

When contrast-enhanced spine MRI?

Post-op (fibrosis vs recurrent herniation), suspected infection (spondylodiscitis, epidural abscess), primary/metastatic tumor and active inflammatory lesion.

Acute lumbar pain — when MRI?

Only with red flags: progressive neurologic deficit, fever, significant trauma, suspected malignancy, cauda equina syndrome, or refractory pain > 4–6 weeks.

Report template — MRI of coluna dorsal

When to use

Spine MRI is the method of choice for radicular pain, suspected disc herniation, myelopathy, spondylodiscitis, cord lesions and staging of vertebral metastasis. Distinguish from CT, indicated for fractures and bony surgical planning.

What to evaluate

Alignment, disc height and disc signal (degeneration / desiccation).
Protrusions and herniations: location (central, paramedian, foraminal, extraforaminal), neural compression.
Spinal canal: stenosis, myelopathy signs.
Facet joints and ligamentum flavum.
Bone marrow signal, focal lesions, marrow edema.

Interactive template

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Técnica: Sequências ponderadas em T1 e T2, em aquisições multiplanares. Análise: - Manipulação cirúrgica: - Fraturas: ausentes. - Lesões ósseas agressivas: ausentes. - Alinhamentos sagital e coronal: preservados. - Corpos vertebrais: de alturas e sinal medular preservados. - Discos intervertebrais: sem protrusões significativas. - Articulações interfacetárias: preservadas. - Canal vertebral e forames neurais: de amplitude normal. - Medula espinhal: preservada. - Estruturas paravertebrais: sem particularidades. Comparação: Em relação ao exame de não se observam alterações significativas. Conclusão: Exame dentro dos limites da normalidade.

Template in Brazilian Portuguese (clinical reporting language). Adapt to your service protocol. Not medical advice — the physician reviews, edits and signs.

How to use

Replace each [...] with the exam's measurement or descriptor.
Adapt the conclusion to your service protocol before signing.
Use the template as a starting point — not a replacement for physician review.
In Laudos.AI, dictate findings in natural speech and the AI structures text in this format for review.

Frequently asked

Herniation vs disc protrusion — definitions?: Fardon/Milette (2014) standard: bulging = wide base (> 25% of circumference); protrusion = base ≥ length; extrusion = length > base; sequestration = disconnected fragment.
When contrast-enhanced spine MRI?: Post-op (fibrosis vs recurrent herniation), suspected infection (spondylodiscitis, epidural abscess), primary/metastatic tumor and active inflammatory lesion.
Acute lumbar pain — when MRI?: Only with red flags: progressive neurologic deficit, fever, significant trauma, suspected malignancy, cauda equina syndrome, or refractory pain > 4–6 weeks.

References

Fardon DF et al., Spine J 2014 (Lumbar Disc Nomenclature).