Date : 00.00.00
Name of the Patient : Abc XyzLaklmn / M / 60 yrs.
Referred by : Dr. Abc Xyzsrani.
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.
There is slight retrolisthesis of the L5 over the S1 vertebral body. A pseudo-posterior disc bulge with peridiscal osteophytes is noted at the L5-S1 level with indentation on the S1 nerve roots.
A posterior disc bulge is noted at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing.
Anterior disc herniation with peridiscal osteophytes is seen at the L3-L4 level. The lumbar intervertebral discs show loss of water content.
The lumbar facet joints and the D12-L1 facet joints show hypertrophic degenerative changes.
Ligamentum flavum hypertrophy is noted at the L4-L5, L5 and L5-S1 levels.
The lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the D12-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 :
17.0 mm at L1-L2
15.0 mm at L2-L3
16.0 mm at L3-L4
13.0 mm at L4-L5
11.0 mm at L5-S1.
1. Slight retrolisthesis of the L5 over the S1 vertebral body with a pseudo-posterior disc bulge with peridiscal osteophyte at the L5-S1 level indenting the S1 nerve roots.
2. A posterior disc bulge at the L4-L5 level.
3. Hypertrophic facetal arthropathy in the lumbar region and at the D12-L1 level with ligamentum flavum hypertrophy at the L4-L5, L5 and L5-S1 levels.
4. Tight lumbar canal at the L4-L5 and L5-S1 levels.