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sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyz. Mlmn / F / 20 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with numbness since 2 months.

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 appears to be sacralization of the L5 vertebra and the L3 vertebral body is as marked on the film. Please correlate with plain radiographs.

There is loss of water content of the L3-L4 and L4-L5 intervertebral discs.

A fairly large, postero-central and left paracentral extruded disc is noted at the L4-L5 level with indentation on the anterior dural theca. Slight inferior migration of the disc fragment is noted with indentation on the traversing left L5 nerve root. Facetal hypertrophy is noted at the L4-L5 level.

Postero-central protruded discs are noted at the L3-L4 and L5-S1 levels .

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The remaing facet joints and the visualised pre and paravertebral soft tissues are unremarkable.
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The conus medullaris terminates at the D12 level and the thecal sac terminates at the S1 level.

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

20.0 mm at L1-L2

19.0 mm at L2-L3

15.0 mm at L3-L4

10.0 mm at L4-L5

11.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.

2. A fairly large, postero-central and left paracentral extruded disc at the L4-L5 level with slight inferior migration of the disc fragment with indentation on the traversing left L5 nerve root.

3. Postero-central protruded discs at the L3-L4 and L5-S1 levels.

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