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sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE and paresthesias.

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 reduction in height of nearly all the visualized dorso-lumbar intervertebral discs with loss of water content.

There is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra with probable spondylolysis at L3 and L4, bilaterally. Please correlate with plain radiographs. There is mild forward translation of the L3 vertebra over the L4 vertebra and mild retroplacement of the L1 over the L2 and L2 over the L3 vertebrae.

There is anterior wedging of the D12, L1 and L2 vertebral bodies and central wedging of the L3 vertebral body. The D12 and L2 vertebral bodies show diffuse fatty marrow changes. The L1 vertebral body shows a hypointense signal on all the pulse sequences along its superior half.

Posteriorly bulging discs with posterior peridiscal osteophytes are noted over the L1-L2 to L4-L5 levels. Bilateral neural foraminal narrowing is noted at the L4-L5 level with impingement of the exiting L4 nerve roots. Bilateral neural foraminal narrowing is also seen at the L1-L2, L2-L3 and L3-L4 levels.
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Facetal hypertrophy is seen over the L2-L3 to L5-S1 levels. Ligamentum flavum hypertrophy is seen at the L2-L3 and L3 levels.

Bilateral far lateral disc bulges are seen at the L4-L5 and L3-L4 levels.

Postero-central disc herniations with peridiscal osteophytes is noted at the D11-D12 and D12-L1 levels indenting the dural theca anteriorly. There is central herniation of the L2-L3 intervertebral disc into the body of L3.

Anterior disc herniations with anterior peridiscal osteophytes are noted in the lumbar region.

The rest of the lumbar vertebral bodies also show spotty fatty marrow changes. 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
15.0 mm at L2-L3
12.0 mm at L3-L4
11.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L4 over the L5 vertebra with probable spondylolysis at L3 and L4, bilaterally. Also seen is mild forward translation of the L3 vertebra over the L4 vertebra and mild retroplacement of the L1 over the L2 and L2 over the L3 vertebrae.
..3/.





- 3 - Scan-00003


2. Changes in the D12, L1, L2 and L3 vertebral bodies may be the sequelae of previous trauma (superimposed on an osteoporotic spine).

3. Posteriorly bulging discs with posterior peridiscal osteophytes over the L1-L2 to L4-L5 levels. Bilateral neural foraminal narrowing is noted at the L4-L5 level with impingement of the exiting L4 nerve roots at the L4-L5 level.

4. Facetal hypertrophy is noted over the L2-L3 to the L5-S1 levels with ligamentum flavum hypertrophy at the L2-L3 and L3 levels.

5. Postero-central disc herniations with peridiscal osteophytes at the D11-D12 and D12-L1 levels.

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