ke/hs/rp/nl





Name of the Patient : Abc Xyzd Huslmn / M / 50 yrs.
Referred by : Dr. Abc Xyzsari.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache.

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 :

There is probable spondylolysis at the L3 level bilaterally. However, please correlate with plain radiographs.

There is reduction in the height of the L3-L4 intervertebral discs and it is dessicated.

A diffuse posterior disc herniation with peridiscal osteophytes is seen at the L3-L4 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. A large anterior disc herniation with peridiscal osteophytes is also noted at this level. Bilateral far lateral disc herniations with peridiscal osteophytes are also seen at this level, minimally indenting the extra-foraminal segments of the exiting L3 nerve roots.

A posterior disc bulge with peridiscal osteophytes is seen at the L4-L5 level with anterior indentation of the thecal sac and mild bilateral neural foraminal narrowing.


A postero-central disc herniation with peridiscal osteophytes is seen at the L5-S1 level.

Small bilateral postero-lateral disc bulges are noted at the L2-L3 level. Far lateral disc bulges are seen bilaterally at the L2-L3, L4-L5 and L5-S1 levels.

The L3-L4, L4-L5 and L5-S1 facet joints show hypertrophic degenerative changes. Mild facetal hypertrophy is noted in the rest of the lumbar region.

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

Type II/III degenerative marrow changes are seen in the L3 and L4 vertebral bodies adjacent to the L3-L4 intervertebral disc.

There is slight anterior wedging of the D12, L1 and L2 vertebral bodies.

The lumbar vertebral bodies show spotty fatty marrow changes. The remaining lumbar intervertebral discs show mild loss of water content. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S2 level.

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

13.0 mm at L1-L2
13.0 mm at L2-L3
10.0 mm at L3-L4
13.0 mm at L4-L5
12.0 mm at L5-S1.
..3/.









- 3 - Scan-00002

IMPRESSION :

The MRI features are suggestive of :

1. Probable spondylolysis at the L3 level bilaterally. Please correlate with plain radiographs.

2. A diffuse posterior disc herniation with peridiscal osteophytes at the L3-L4 level with a resultant tight canal.

3. Bilateral far lateral disc herniations at the L3-L4 level with minimal indentation upon the extraforaminal segment of the exiting L3 nerve roots.

4. A postero-central disc herniation with peridiscal osteophytes at the L5-S1 level.

5. Hypertrophic facetal arthropathy at the L3-L4, L4-L5 and L5-S1 levels.

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