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Date : 00.00.00

Name of the Patient : Abc Xyz P. lmn / F / 42 yrs.
Referred by : Dr. Abc Xyzhah / Dr. Abc Xyzehta.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the LUE with numbness since 1 week.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is loss of normal cervical lordosis and loss of water content of the C4-C5 and C5-C6 intervertebral discs.

There is a fairly large left postero-lateral disc herniation at the C5-C6 level with ventral indentation upon the spinal cord and the left C6 nerve root. A part of the disc fragment is seen to migrate superiorly and inferiorly, posterior to the C5 and C6 vertebrae in the left lateral recess.

A postero-central disc protrusion is seen at the C6-C7 level with ventral indentation of the thecal sac.

Focal disc protrusions are seen at the C2-C3 and C3-C4 levels.

Mild hypertrophy of the facet joints is seen at the C5-C6 level.


The cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

IMPRESSION :

The MRI features are suggestive of a fairly large left postero-lateral disc herniation at the C5-C6 level with ventral indentation upon the spinal cord and the left C6 nerve root with a part of the disc fragment seen to migrate superiorly and inferiorly, posterior to the C5 and C6 vertebrae in the left lateral recess.


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