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Name of the Patient : Abc Xyza S. Blmn / F / 30 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE (right more than left) with paresthesias since 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.

OBSERVATION :

There is sacralization of the L5 vertebra.

There is loss of water content of the lumbar intervertebral discs. The L4-L5 intervertebral disc is decreased in height.

There is slight retroplacement of the L4 vertebra over the L5 vertebra.

There is a posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing L5 nerve roots bilaterally. Slight facetal and ligamentum flavum hypertrophy is noted with canal stenosis. Bilateral far lateral disc herniations are seen at the L4-L5 level. There is probable inflammation of the traversing right L5 nerve root.

A posterior disc bulge is noted at the L3-L4 level with slight bilateral neural foraminal narrowing.

A right paracentral disc herniation with peridiscal osteophytes is noted at the L2-L3 level.
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A small right paracentral protruded disc is noted at the L1-L2 level.

Mild facetal hypertrophy is seen at the L2-L3 and L3-L4 levels.

Type I/Type II degenerative marrow changes are noted adjacent to the L4-L5 disc.

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 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
15.0 mm at L2-L3
14.0 mm at L3-L4
14.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. Slight retroplacement of the L4 vertebra over the L5 vertebra.

3. A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level indenting the traversing L5 nerve roots bilaterally. Slight facetal and ligamentum flavum hypertrophy is also noted with canal stenosis.

4. A right paracentral disc herniation with peridiscal osteophytes at the L2-L3 level.

5. Bilateral far lateral (extraforaminal) disc herniations at the L4-L5 level.
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