Date : 00.00.00
Name of the Patient : Abc Xyzai Plmn / M / 55 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O numbness in the RLE on standing and walking for a long distance.
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.
SOME IMAGES SHOW PATIENT MOTION.
There is loss of normal lumbar lordosis. The lumbar intervertebral discs show mild loss of water content.
A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L3-L4 level. The facet joints at this level show hypertrophic degenerative changes. Also seen is ligamentum flavum hypertrohy at this level with canal stenosis.
Posterior disc bulges are noted at the L2-L3, L4-L5 and L5-S1 levels. The facet joints at these levels show degenerative changes with resultant tight lumbar canal over the L2-L3 and L4-L5 levels.
Bilateral far lateral (extraforaminal) disc bulges are noted in the lumbar region.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
Multiple Schmorls nodes are noted in the dorso-lumbar region.
Anterior peridiscal osteophytes are seen at the L1-L2 and L2-L3 levels.
The lumbar vertebral bodies 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 :
12.0 mm at L1-L2
10.0 mm at L2-L3
9.0 mm at L3-L4
12.0 mm at L4-L5
10.0 mm at L5-S1.
The MRI features are suggestive of :
1. A posterior disc herniation with severe hypertrophic facetal arthropathy and severe canal stenosis at the L3-L4 level.
2. Posterior disc bulges at the L2-L3, L4-L5 and L5-S1 levels with facetal arthropathy.
3. A tight canal at the L2-L3 and L4-L5 levels.