Date : 00.00.00
Name of the Patient : Abc XyzWlmn / F / 75 yrs.
Referred by : Dr. Abc Xyzchha.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to the LLE.
H/O fall many years ago.
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 scoliosis of the lumbar spine with convexity to the left.
The L5-S1 and the D12-L1 intervertebral discs are reduced in height. The D11-D12 intervertebral disc shows a hyperintense signal on all the pulse sequences which may suggest discal calcification. The L4-L5 disc appears slightly hyperintense on the T2 Weighted images. The rest of the lumbar intervertebral discs show loss of water content.
There is slight wedging of the L3 and L4 vertebral bodies which appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Mild generalized bulge of these vertebral bodies is noted. The cortical endplates appear to be intact. Herniation of the L3-L4 intervertebral disc into the body of L4 is noted.
Similar changes but to a much lesser extent are noted adjacent to the superior cortical endplate of L1. The D12 vertebral body is wedged, anteriorly, with fatty marrow changes.
There are bilateral far lateral disc bulges at the L5-S1 level with indentation upon the extraforaminal portion of the L5 nerve roots. A small posterior disc bulge with posterior peridiscal osteophyte is also noted at this level.
A posterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The L4-L5 facet joints show hypertrophic degenerative changes with resultant lateral canal stenosis. There is suggestion of fusion within the L4-L5 facets.
A posterior and left far lateral disc bulge is seen at the L3-L4 level with mild left neural foraminal narrowing. The L3-L4 facet joints show mild degenerative changes.
A diffuse posterior disc herniation is seen at the L2-L3 level with narrowing of the right neural foramina. The L2-L3 facet joints on the right side shows degenerative change.
Anterior disc herniations with anterior peridiscal osteophytes are noted at the dorso-lumbar and lumbar regions.
The rest of the visualized lumbar vertebral bodies show spotty fatty marrow changes. 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.
The lower dorsal spinal cord shows normal signal.
- 3 - Scan-00001
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
19.0 mm at L1-L2
11.0 mm at L2-L3
18.0 mm at L3-L4
11.0 mm at L4-L5
9.0 mm at L5-S1.
Screening, T1 Weighted sagittal images of the dorsal spine reveal fatty marrow changes in the visualized dorsal vertebrae except the D8 vertebral body which shows a hypointense signal. Central wedging of the D4 vertebral body is noted.
1. Slight wedging of the L3 and L4 vertebral bodies with altered signal suggest bone bruise, the sequelae of compression fractures superimposed on and osteoporotic spine.
2. Central wedging of L1, D4 and anterior wedging of the D12 vertebral bodies may also be the sequelae of osteoporotic fractures.
3. Bilateral far lateral disc bulges at the L5-S1 level with indenation upon the extraforaminal portion of the L5 nerve roots.
4. A posterior disc herniation at the L4-L5 level with hypertrophic facetal arthropathy and resultant lateral canal stenosis.
5. A posterior and left far lateral disc bulge at the L3-L4 level with facetal arthropathy.
6. A diffuse posterior disc herniation at the L2-L3 level with mild facetal arthropathy.