sb/ke/rg/nl
Name of the Patient : Abc XyzSallmn / M / 45 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE with 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 loss of normal lumbar lordosis and loss of water content of the L1-L2, L4-L5 and L5-S1 intervertebral discs.
There is a fairly large, postero-central and left paracentral extruded disc with a peridiscal osteophyte at the L5-S1 level with thecal sac compression. Inferior migration of the disc fragment into the left lateral recess of S1 is noted with indentation on the traversing left S1 nerve root. Slight facetal hypertrophy is also noted at this level.
A small postero-central disc herniation is noted at the L4-L5 level with slight facetal hypertrophy at that level.
A small left paracentral disc herniation is seen at the L1-L2 level.
Type II degenerative changes are noted adjacent to the L5-S1 disc.
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The rest of the lumbar vertebral bodies and the remaining intervertebral discs 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 S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
15.0 mm at L1-L2
19.0 mm at L2-L3
19.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.
IMPRESSION :
1. A fairly large, postero-central and left paracentral extruded disc with a peridiscal osteophytes at the L5-S1 level with inferior migration of the disc fragment into the left lateral recess of S1 and indentation on the traversing left S1 nerve root. Slight facetal hypertrophy is also noted at this level.
2. A small postero-central disc herniation at the L4-L5 level with slight facetal hypertrophy at that level.
3. A small left paracentral disc herniation at L1-L2 level.