Name of the Patient : Abc Xyznisa lmn / F / 66 yrs.
Referred by : Dr. Abc Xyzaria / Dr. Abc Xyzhha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE.

EXAMINATION :

M.R.I. of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The L5 vertebra is as marked on the film. Please correlate with plain radiographs.

There is scoliosis of the lumbar spine with convexity to the left and clockwise rotation of the lumbar vertebrae.

The lumbar intervertebral discs show loss of water content with evidence of calcium/vacuum phenomena within these discs.

There is Grade I spondylolisthesis of the L3 over the L4 and L4 over the vertebrae. Also seen is retroplacement of the L1 over L2 and L2 over L3 vertebrae. There is right lateral wedging of the L2 over the L3 vertebral bodies.

There is a large posterior disc herniation with peridiscal osteophytes compressing the thecal sac and narrowing both neural foramina at the L4-L5 level. ca
Scan-00006

There are posterior disc herniations with peridiscal osteophytes indenting the thecal sac and narrowing both neural foramina at the L1-L2, L2-L3, L3-L4 and L5-S1 levels.

Bilateral far lateral disc herniations are noted over the L1-L2 to L5-S1 levels.

The L2-L3, L3-L4 and L4-L5 facet joints bilaterally and the left facet joint at the L5-S1 level show severe hypertrophic degenerative changes. Ligamentum flavum hypertrophy is noted at these levels. The right L5-S1 facet joint shows mild degenerative changes.

The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.

The lumbar vertebral bodies show fatty marrow changes.
The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1-S2 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

14.0 mm at L1-L2
12.0 mm at L2-L3
7.0 mm at L3-L4
8.0 mm at L4-L5
6.0 mm at L5-S1.

The visualized urinary bladder is markedly distended.





- 3 - Scan-00006

IMPRESSION :

The MRI features are suggestive of :

1. Scoliosis of the lumbar spine as described with Grade I spondylolisthesis of the L3 over the L4 and L4 over the L5 vertebrae with retroplacement of the L1 over L2 and L2 over L3 vertebrae.

2. A large posterior disc herniation with peridiscal osteophytes at the L4-L5 level with canal stenosis.

3. Posterior disc herniations with peridiscal osteophytes at the L1-L2, L2-L3, L3-L4 and L5-S1 levels with a tight canal at these levels.

4. Bilateral far lateral disc herniations over the L1-L2 to L5-S1 levels.

5. Severe hypertrophic facetal arthropathy at the L2-L3, L3-L4 and L4-levels, bilaterally and on the left side at the L5-S1 level.

6. Ligamentum flavum hypertrophy L2-L3, L3-L4, L4-L5 and L5-S1 levels.

7. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.

As compared to the previous MRI dated 00.00.0000 [Study No.00009], there is no significant change.