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Date : 00.00.00

Name of the Patient : Abc XyzNoorulmn / F / 65 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 6 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 is Grade I spondylolisthesis of the L4 over the L5 vertebra, without obvious spondylolysis.

Minimal pseudoposterior disc bulge is noted at the L4-L5 level with slight left neural foraminal narrowing.

A left far lateral disc bulge is also noted at this level.

A minimal posterior disc bulge is noted at the L3-L4 level.

Hypertrophic facetal arthropathy is noted at the L4-L5 an L5-S1 levels on the left. There is also capsular ligament hypertrophy at the L4-L5 level with canal stenosis at the L4-L5 and L5-S1 levels.

The lumbar vertebral bodies show fatty marrow changes suggesting osteoporosis. The lumbar intervertebral discs except the L5-S1 disc show loss of water content. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S1 level.
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The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

15.0 mm at L1-L2

13.0 mm at L2-L3

13.0 mm at L3-L4

10.0 mm at L4-L5

8.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L4 over the L5 vertebra, without obvious spondylolysis.

2. Minimal pseudoposterior disc bulge with a left far lateral disc bulge at the L4-L5 level.

3. Hypertrophic facetal arthropathy at the L4-L5 an L5-S1 levels on the left and capsular ligament hypertrophy at the L4-L5 level with canal stenosis at the L4-L5 and L5-S1 levels.


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    • Million Muskmelons
    • Interventional Pain Procedure Templates
    • The Ultimate Guide to Rapid Reporting for FRCR 2B
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