Sb/hs/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzai D. Choulmn / F / 45 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with paresthesias since 7 years with bladder/bowel dysfunction since 15 days.
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 Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra without obvious spondylolysis. A resultant, fairly large posterior disc herniation is noted at the L4-L5 level with thecal sac compression and bilateral neural foraminal narrowing. A right postero-lateral and right far lateral disc herniation is also noted at this level with a disc fragment in the right neural foramen at the L4-L5 level. There is compression of the exiting L4 and the traversing L5 nerve roots bilaterally. There is also hypertrophic facetal arthropathy with resultant severe canal stenosis at this level. A small left far lateral disc herniation is also seen at the L4-L5 level.
There is a postero-central and left postero-lateral disc herniation at the L5-S1 level with left neural foraminal narrowing and indentation on the traversing left S1 nerve root.
A posteriorly herniated disc is noted at the L3-L4 level with thecal sac compression and bilateral neural foraminal narrowing. There is impingement of the exiting left L3 nerve root in the left neural foramen at the L3-L4 level. A left far lateral (extraforaminal) disc herniation is noted at this level.
A small postero-central disc herniation is noted at the L2-L3 level.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
Facetal hypertrophy is noted in the lumbar region.
A hemangioma with fat content is noted in the D11 and D12 vertebral bodies.
The lumbar vertebral bodies reveal normal signal intensity. The lumbar intervertebral discs show loss of water 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 S1 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
13.0 mm at L1-L2
10.0 mm at L2-L3
9.0 mm at L3-L4
5.0 mm at L4-L5
7.0 mm at L5-S1.
Screening T2 Weighted sagittal images of the dorsal spine reveal small postero-central protruded discs with peridiscal osteophytes at the D6-D7, D7-D8 and D8-D9 levels indenting the dorsal spinal cord anteriorly. The dorsal spinal cord however shows normal signal intensity.
..3/.
- 3 - Scan-00004
IMPRESSION :
1. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra without obvious spondylolysis.
2. A fairly large, posterior disc herniation at the L4-L5 level with a right postero-lateral and far lateral disc herniation at this level and a disc fragment in the right neural foramen at the L4-L5 level with compression of the exiting L4 and the traversing L5 nerve roots bilaterally. There is also hypertrophic facetal arthropathy with resultant severe canal stenosis at this level.
3. A postero-central and left postero-lateral disc herniation at the L5-S1 level with left neural foraminal narrowing and indentation on the traversing left S1 nerve root.
4. A posteriorly herniated disc at the L3-L4 level with bilateral neural foraminal narrowing and impingement of the exiting left L3 nerve root in the left neural foramen at the L3-L4 level. A left far lateral disc herniation is seen at this level.
5. A small posterior disc herniation at the L2-L3 level.
6. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.
7. Lower lumbar canal stenosis.
8. Small postero-central protruded discs with peridiscal osteophytes at the D6-D7, D7-D8 and D8-D9 levels indenting the dorsal spinal cord anteriorly.