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hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzli Shlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to LLE and left gluteal region since 7 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 loss of normal lumbar lordosis. There slight retroplacement of the L5 vertebra over the S1 vertebra.

A large postero-central disc herniation with a peridiscal osteophyte is seen to indent the thecal sac at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the S1 vertebra with impingement of the traversing left S1 nerve root. A left postero-lateral (foraminal) disc herniation is seen to narrow the left neural foramina at the L5-S1 level. This intervertebral disc shows loss of water content.

Bilateral (left more than right) postero-lateral (foraminal) disc herniations are seen to narrow the neural foramina at the L4-L5 level.

Bilateral far lateral (extraforaminal) disc bulges are seen at the L3-L4, L4-L5 and L5-S1 levels.

The pedicles of the lower lumbar vertebrae appear to be congenitally short in their antero-posterior dimensions.
..2/.






The facet joints at the L4-L5 and L5-S1 levels appear slightly hypertrophied.

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 L1 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 :

15.0 mm at L1-L2
16.0 mm at L2-L3
13.0 mm at L3-L4
11.0 mm at L4-L5
5.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A large postero-central disc herniation with a peridiscal osteophyte and canal stenosis at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the S1 vertebra with impingement of the traversing left S1 nerve root.

2. A left postero-lateral (foraminal) disc herniation
at the L5-S1 level.

3. Bilateral (left more than right) postero-lateral (foraminal) disc herniations at the L4-L5 level.

4. Congenitally short pedicles of the lower lumbar vertebrae in their antero-posterior dimensions.

5. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.

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