Name of the Patient : Abc XyzRulmn / M / 45 yrs.
Referred by : Dr. Abc Xyzenoy.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE.
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.
The lumbar intervertebral discs (especially at the L4-L5 and L5-S1 levels) show loss of water content.
Postero-central disc herniations with peridiscal osteophytes are seen to indent the thecal sac at the L4-L5 and L5-S1 levels.
A right postero-lateral disc herniation is seen to indent the exiting right S1 nerve root at the L5-S1 level. A left postero-lateral disc herniation is seen to indent the exiting left L4 nerve root at the L4-L5 level. Also seen is neural foraminal narrowing on the right side at the L5-S1 level and on the left side at the L4-L5 level.
Bilateral far lateral (extraforaminal) disc bulges are seen at the L4-L5 and L5-S1 levels.
A posterior disc bulge with peridiscal osteophytes is noted at the L2-L3 level.
There is facetal hypertrophy at the L4-L5 and L5-S1 levels.
Type II degenerative marrow changes are noted adjacent to the L5-S1 disc.
The rest of the lumbar vertebral bodies reveal normal signal intensity. The remaining 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 S2 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
14.0 mm at L2-L3
15.0 mm at L3-L4
11.0 mm at L4-L5
12.0 mm at L5-S1.
The MRI features are suggestive of :
1. Postero-central disc herniations with peridiscal osteophytes at the L4-L5 and L5-S1 levels.
2. Postero-lateral disc herniations on the left side at the L4-L5 level and on the right side at the L5-S1 level.