Date : 00.00.00
Name of the Patient : Abc Xyz Jamalulmn / F / 64 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to BLE with paresthesias (left more than right) since 2-3 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.
There is sacralization of the L5 vertebra and the L2 vertebral body is as marked on the film. Correlation with plain radiographs would be worthwhile.
The D12-L1, L1-L2 and L2-L3 intervertebral discs show loss of water content.
A small, right paracentral disc herniation is seen at the L1-L2 level with mild antero-lateral indentation of the thecal sac.
The left L5 nerve root appears to be of larger calibre A ? baggy nerve root sleeve ?? inflammation.
A small posterior disc bulge is identified at the L4-L5 level.
The remaining intervertebral discs show normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable. The lumbar vertebral bodies show spotty fatty changes suggestive of osteoporosis.
The conus medullaris terminates at the D12-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 :
19.0 mm at L1-L2
19.0 mm at L2-L3
- 2 -
18.0 mm at L3-L4
15.0 mm at L4-L5
11.0 mm at L5-S1.
1. Probable sacralization of the L5 vertebra. Correlation with plain radiographs would be worthwhile.
2. A small, right paracentral disc herniation at the L1-L2 level.