Date : 00.00.00
Name of the Patient : Abc XyzSlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzq.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to the LLE since 15 years.
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.
The L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.
Slight retroplacement of the L3 over the L4 vertebra is noted.
There is a left paracentral disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing, left more than right.
A large postero-central disc herniation is seen at the L3-L4 level with anterior compression of the thecal sac. There is superior migration of the disc posterior to the L3 vertebral body.
A small posterior disc bulge is noted at the L5-S1 level. Posterior peridiscal osteophytes are noted at the L3-L4, L4-L5 and L5-S1 levels.
The L5-S1 facet joint on the left side and at the L3-L4 level bilaterally show degenerative changes.
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 :
14.0 mm at L1-L2
13.0 mm at L2-L3
11.0 mm at L3-L4
10.0 mm at L4-L5
10.0 mm at L5-S1.
The MRI features are suggestive of :
1. A left paracentral disc herniation at the L4-L5 level.
2. A large postero-central disc herniation at the L3-L4 level.
3. Facetal arthropathy at the L5-S1 level on the left side and at the L3-L4 level, bilaterally.