Date : 00.00.00
Name of the Patient : Abc Xyzha B. Blmn / F / 39 yrs.
Referred by : Dr. Abc Xyz Sane.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE and 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 a posterior and right postero-lateral disc herniation at the L4-L5 level with anterior indentation of the thecal sac and right neural foraminal narrowing. Mild indentation upon the extraforaminal portion of the right L4 nerve root is noted. Posterior peridiscal osteophytes are also seen at this level.
Small posterior and left paracentral disc herniations with peridiscal osteophytes is noted at the L5-S1 level. The L4-L5 and L5-S1 intervertebral discs show loss of water content.
The facet joints at the L5-S1 level appear slightly hypertrophied.
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 :
17.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
11.0 mm at L4-L5
10.0 mm at L5-S1.
1. A posterior and right postero-lateral disc herniation at the L4-L5 level with mild indentation upon the extraforaminal portion of the right L4 nerve root.
2. Small posterior and left paracentral disc herniations with peridiscal osteophytes at the L5-S1 level.