hs/bv/nl/rg.

Name of the Patient : Abc Xyz R. Motlmn / M / 64 yrs.
Referred by : Dr. Abc Xyzshru.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain to the LLE.

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 lumbar intervertebral discs show loss of water content.

A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level, left more than right with indentation upon the exiting L4 and traversing left L5 nerve root.

A mild posterior disc bulge is noted at the L5-S1 level. There are bilateral far lateral disc bulges over the L2-L3 to L5-S1 levels.

The L2-L3 facet joints show severe hypertrophic degenerative changes. The L1-L2 facet joints show degenerative changes.

Facetal hypertrophy is noted at the L3-L4 and L4-L5 levels. Also seen is mild facetal hypertrophy at the L5-S1 level.

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

The lumbar vertebral bodies show areas of fatty replacement of normal marrow which may suggest osteoporotic changes.
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Fat is noted within the filum terminale over the L2 to L4-L5 levels (? normal variant ? fibrolipoma).

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 :

17.0 mm at L1-L2
16.0 mm at L2-L3
16.0 mm at L3-L4
12.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation with a tight canal at the L4-L5 level with indentation upon the traversing L5 and exiting L4 nerve roots.

2. Severe hypertrophic facetal arthropathy at the L2-L3 level with facetal arthropathy at the L1-L2 level.

3. Facetal hypertrophy at the L3-L4 and L4-L5 levels.

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