Date : 00.00.00
Name of the Patient : Abc Xyzllah Chaudlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzal S. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with radicular pain in BLE with numbness since 1 year.
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.
A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. The facet joints at this level shows hypertrophic degenerative changes. Also seen is ligamentum flavum hypertrophy with severe canal stenosis at this level. Bilateral far lateral (extraforaminal) disc herniations are noted at this level.
A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L3-L4 level.
There is a postero-central disc protrusion at the L5-S1 level.
Bilateral far lateral (extraforaminal) disc bulges are noted at the L1-L2, L2-L3, L3-L4 and L5-S1 levels. The rest of the facet joints in the lumbar region show degenerative changes.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
The lumbar intervertebral discs show loss of water content.
A focal area of hyperintensity on the T1 Weighted images within the L3 vertebral body on the left side may represent a focal deposit of fat/hemangioma.
A Schmorls node is noted at the inferior aspect of the L1 vertebral body.
The rest of the lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the D12 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 :
13.0 mm at L1-L2
11.0 mm at L2-L3
10.0 mm at L3-L4
7.0 mm at L4-L5
8.0 mm at L5-S1.
Incidentally noted is a large right cortical renal cyst.
The MRI features are suggestive of :
1. A posterior disc herniation with hypertrophic facetal arthropathy and ligamentum flavum hypertrophy with severe canal stenosis at the L4-L5 level.
2. Bilateral far lateral (extraforaminal) disc herniations at the L4-L5 level.
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3. A small posterior disc herniation at the L3-L4 level.
4. A postero-central disc protrusion at the L5-S1 level.
5. Facetal arthropathy in the lumbar region except at the L4-L5 level.
6. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.