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hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Anlmn / F / 43 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache and pain 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 mild forward listhesis of the L3 over the L4 vertebra.

A postero-central disc herniation is seen to indent the thecal sac at the L3-L4 level. There is a posterior disc bulge at the L4-L5 level.

The L3-L4 and L4-L5 facet joints show hypertrophic degenerative changes. The L1-L2, L2-L3 and L5-S1 facet joints show degenerative changes. Effusion is noted within the facet joints bilaterally at the L3-L4 level and on the right side at the L2-L3 and L4-L5 levels.

Ligamentum flavum hypertrophy is seen at the L3-L4 and L4-L5 levels. A small well circumscribed lesion which is hypointense on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted images is seen within the right posterior epidural space at the L3-L4 level and this may represent a synovial cyst.


The lumbar intervertebral discs show loss of water content.

The lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

18.0 mm at L1-L2
16.0 mm at L2-L3
14.0 mm at L3-L4
13.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Mild forward listhesis of the L3 over the L4 vertebra.

2. A postero-central disc herniation at the L3-L4 level.

3. Hypertrophic facetal arthropathy at the L3-L4 and L4-L5 levels.

4. Facetal arthropathy at the L1-L2, L2-L3 and L5-S1 levels.

5. Ligamentum flavum hypertrophy at the L3-L4 and L4-L5 levels

6. A probable synovial cyst within the right posterior epidural space at the L3-L4 level.

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