Date : 00.00.00
Name of the Patient : Abc Xyzulrelmn / M / 28 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to BLE (left more than right) with paresthesias.
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.
FEW IMAGES SHOW PATIENT MOTION.
There is loss of water content of the L4-L5 and L5-S1 intervertebral discs.
There is a postero-central protruded disc at the L5-S1 level.
There is a fairly large, postero-central and left paracentral extruded disc with a peridiscal osteophyte at the L4-L5 level (with slight inferior migration of the disc fragment) impinging the traversing left L5 nerve root. Bilateral neural foraminal narrowing is noted at this level. The facet joints show hypertrophic degenerative changes at this level with a resultant tight canal.
Focal fatty marrow changes are noted within the L2 vertebral body.
The L3-L4 and L5-S1 facet joints show degenerative changes.
The rest of 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 S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
17.0 mm at L1-L2
14.0 mm at L2-L3
15.0 mm at L3-L4
8.0 mm at L4-L5
10.0 mm at L5-S1.
1. A fairly large, postero-central and left paracentral extruded disc with a peridiscal osteophyte at the L4-L5 level (with slight inferior migration of the disc fragment) impinging the traversing left L5 nerve root. Bilateral neural foraminal narrowing and hypertrophic facetal arthropathy with a resultant tight canal is also noted.
2. A postero-central protruded disc at the L5-S1 level.