Date : 00.00.00
Name of the Patient : Abc Xyzdin lmn / M / 60 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to the LLE with paresthesias.
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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.
There is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.
A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. The L4-L5 facet joints show hypertrophic degenerative changes. There is ligamentum flavum hypertrophy at this level.
A posterior disc bulge is noted at the L3-L4 level.
The L3-L4 and L4-L5 intervertebral discs show loss of water content.
An anterior disc herniation is seen at the D10-D11 level.
The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
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 :
14.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
11.0 mm at L4-L5
10.0 mm at L5-S1.
The MRI features are suggestive of :
1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.
2. A small posterior disc herniation, ligamentum flavum hypertrophy and hypertrophic facetal arthropathy with canal stenosis at the L4-L5 level.
3. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.