Date : 00.00.00
Name of the Patient : Abc XyzAmbardlmn / M / 77 yrs.
Referred by : Dr. Abc Xyzlke.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to the LLE since 10 months.
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.
The lumbar intervertebral discs show loss of water content.
There is sacralization of the L5 vertebra and it is as marked on the film.
There is mild retroplacement of the L3 over the L4 and L4 over the L5 vertebrae.
Posterior disc herniations with peridiscal osteophytes are seen to indent the thecal sac and narrow both neural foramina at the L3-L4 and L4-L5 levels. Bilateral far lateral (extraforaminal) disc herniations are also noted at these levels.The facet joints at the L4-L5 level show hypertrophic degenerative changes. Ligamentum flavum hypertrophy is also noted at this level with canal stenosis.
A large right postero-lateral (foraminal) disc herniation is noted at the L3-L4 level. Also seen is facetal hypertrophy at this level.
A right far lateral disc herniation with peridiscal osteophytes is noted at the L5-S1 level.
Anterior disc herniations are seen at the L2-L3, L3-L4 and L4-L5 levels.
The lumbar vertebral bodies show fatty areas of replacement of normal marrow. Schmorls nodes are seen in the L3, L4 and L5 vertebrae adjacent to the L3-L4 and L4-L5 discs.
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The rest of the facet joints and 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 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
10.0 mm at L3-L4
8.0 mm at L4-L5
7.0 mm at L5-S1.
The MRI features are suggestive of :
1. Sacralization of the L5 vertebra .
2. A posterior disc herniation with peridiscal osteophytes and facetal hypertrophy at L3-L4 level with canal stenosis at this level.
3. Hypertrophic facetal arthropathy with ligamentum flavum hypertrophy
and severe canal stenosis at the L4-L5 level.
4. Bilateral far lateral (extraforaminal) disc herniations at the L3-L4 and L4-L5 levels.
5. A posterior disc herniation with peridiscal osteophytes at the L4-L5 level.
6. A large right postero-lateral disc herniation at the L3-L4 level.