hs/ke/rg/nl
Date : 00.00.00
Name of the Patient : Abc XyzF. Al-Kuwlmn / M / 65 yrs.
Referred by : Dr. Abc Xyz Naik.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE since 1 year.
EXAMINATION :
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.
OBSERVATION :
There is retroplacement of the L3 vertebra over the L4 vertebra and slight forward translation of the L4 vertebra over the L5 vertebra. The visualized dorso-lumbar intervertebral discs except for the L5-S1 disc show loss of water content.
Posterior disc herniations with peridiscal osteophytes are seen to indent the thecal sac and narrow both the neural foramina at the L3-L4 and L4-L5 levels with resultant severe canal stenosis.
The L4-L5 facet joints show severe hypertrophic degenerative changes. The L2-L3, L3-L4 and L5-S1 facet joints show hypertrophic degenerative changes.
Bilateral postero-lateral disc herniations with neural foraminal narrowing are seen at the L2-L3 level. Bilateral far lateral (extraforaminal) disc herniations are seen over the L1-L2 to L5-S1 levels.
The L1-L2 facet joints show degenerative changes. There is ligamentum flavum hypertrophy over the L3 to the L5 level.
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The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
Posterior disc bulges are noted at the D10-D11 and D11-D12 levels.
Schmorls nodes are seen at the L3-L4 level. Anterior disc herniations with peridiscal osteophytes are noted in the
dorso-lumbar region.
A focal area of hyperintensity on the T1 Weighted images is seen within the L5 vertebral body and may represent a hemangioma with high fat content.
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 :
16.0 mm at L1-L2
15.0 mm at L2-L3
8.0 mm at L3-L4
7.0 mm at L4-L5
8.0 mm at L5-S1.
IMPRESSION :
The MRI features are suggestive of :
1. Retroplacement of the L3 vertebra over the L4 vertebra with slight forward translation of the L4 vertebra over the L5 vertebra.
2. Posterior disc herniations with peridiscal osteophytes at the L3-L4 and L4-L5 levels with resultant severe canal stenosis.
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3. Severe hypertrophic facetal arthropathy at the L4-L5 level and hypertrophic facetal arthropathy at the
L2-L3, L3-L4 and L5-S1 levels.
4. Bilateral postero-lateral disc herniations at the L2-L3 level.
5. Bilateral far lateral (extraforaminal) disc herniations over the L1-L2 to L5-S1 levels.
6. Congenitally short pedicles of lumbar vertebrae in their antero-posterior dimensions.
7. Tight canal at the L1-L2 and L5-S1 levels.
8. Ligamentum flavum hypertrophy over the L3 to the L5 level.