Date : 00.00.00
Name of the Patient : Abc Xyz Khakholmn / M / 44 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to the LUE and LLE with paresthesias.
H/O TBM with hydrocephalus in May 0000. VP Shunt was done.
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 is loss of water content of the lower lumbar intervertebral discs and loss of normal lumbar lordosis.
A small posterior disc bulge with peridiscal osteophytes is noted at the L5-S1 level.
A small postero-central protruded disc is noted at the L4-L5 level.
Facet joints in the lower lumbar region appear slightly hypertrophied.
Fat is noted in the filum terminale over the L2 to L5 vertebral levels.
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 nerve roots in the lumbar region show normal distribution.
The conus medullaris terminates at the D12 level and the thecal sac terminates at the L5 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
12.0 mm at L1-L2
11.0 mm at L2-L3
12.0 mm at L3-L4
14.0 mm at L4-L5
14.0 mm at L5-S1.
1. A small posterior disc bulge with peridiscal osteophytes at the L5-S1 level.
2. A small postero-central protruded disc at the L4-L5 level.
3. Slight facetal hypertrophy in the lower lumbar region.