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Name of the Patient : Abc XyzDlmn / F / 64 yrs.
Referred by : Dr. Abc Xyzdakia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE.

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 and the L1 vertebra is as marked on the film.

There is Grade II spondylolisthesis of the L4 over the L5 vertebral body with spondylolysis of L4 bilaterally. A pseudoposterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac, bilateral neural foraminal narrowing and impingement of the foraminal portion of the L4 nerve roots. A hypointense signal is seen within the centre of this disc on all pulse sequences suggestive of calcification/vacuum phenomenon.

The L4-L5 facet joint shows mild degenerative changes.

A small posterior disc bulge is seen at the L3-L4 level. The L2-L3 and L3-L4 facet joints show mild degenerative changes.

The lower lumbar intervertebral discs show loss of water content.

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 D12-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 :

20.0 mm at L1-L2
19.0 mm at L2-L3
13.0 mm at L3-L4
12.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. Grade II spondylolisthesis of the L4 over the L5 vertebral body with spondylolysis of L4 bilaterally.

3. A pseudoposterior disc herniation at the L4-L5 level with impingement of the foraminal portion of the L4 nerve roots.

4. Mild facetal arthropathy at the L2-L3, L3-L4 and L4-L5 levels.

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