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hs/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh B. Koylmn / M / 55 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias since 5-6 months.

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.
FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is mild retroplacement of the L3 over the L4 and L4 over the L5 vertebra. The L2-L3 to the L5-S1 interverteral discs show loss of water content.

A posterior disc herniation with peridiscal osteophytes is seen to indent the thecal sac and narrow both neural foramina at the L3-L4 level.

A small posterior disc herniation with peridiscal osteophytes is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level.

Postero-central disc protrusions are seen at the L2-L3 and L5-S1 levels. A small right postero-lateral/far lateral disc bulge is seen to indent the exiting right L2 nerve root at the L2-L3 level.

The L3-L4, L4-L5 and L5-S1 facet joints show degenerative changes.

Bilateral far lateral disc bulges are noted at the L3-L4 and L4-L5 levels.
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The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.

Type II degenerative changes are seen in the L3, L4 and L5 vertebral bodies.

The rest of 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 D12-L1 level and the thecal sac terminates at the S1-S2 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

14.0 mm at L1-L2
11.0 mm at L2-L3
9.0 mm at L3-L4
11.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation with peridiscal osteophytes and resultant canal stenosis at the L3-L4 level.

2. A small posterior disc herniation with peridiscal osteophytes and a resultant tight canal at the L4-L5 level.

3. Facetal arthropathy at the L3-L4, L4-L5 and L5-S1 levels.

4. A small right postero-lateral/far lateral disc bulge indenting the exiting right L2 nerve root at the L2-L3 level.

5. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.
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