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Name of the Patient : Abc Xyzali lmn / M / 55 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE with numbness since 25-26 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 loss of normal lumbar lordosis and loss of water content of nearly all the intervertebral discs except the L1-L2 disc.

A small postero-central disc herniation is noted at the L5-S1 level.

A posterior disc bulge with a left postero-lateral disc herniation is seen at the L4-L5 level with bilateral neural foraminal narrowing. A sequestered disc fragment is noted in the anterior epidural space to the left of the midline at the L4 vertebral level indenting the traversing left L4 nerve root.

A small posterior disc bulge with a central protrusion is noted at the L3-L4 level. A left far lateral disc herniation is also seen at this level with mild left neural foraminal narrowing.

Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.
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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 L1 level and the thecal sac terminates at the S3 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
16.0 mm at L2-L3
17.0 mm at L3-L4
18.0 mm at L4-L5
14.0 mm at L5-S1.

IMPRESSION :

1. A posterior disc bulge with a left postero-lateral disc herniation at the L4-L5 level with bilateral neural foraminal narrowing. A sequestered disc fragment is noted in the anterior epidural space to the left of the midline at the L4 vertebral level indenting the traversing left L4 nerve root.

2. A small postero-central disc herniation at the L5-S1 level.

3. A small posterior disc bulge with a central protrusion and a left far lateral disc herniation at the L3-L4 level.

4. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.

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