Name of the Patient : Abc Xyzglmn / M / 55 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O radicular pain to the RLE with paresthesias.
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.
A right paracentral disc extrusion is seen to indent the thecal sac at the L5-S1 level. A disc portion is seen to lie within the right lateral recess of the S1 vertebra with impingement of the traversing right S1 nerve root.
A large posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level.
A postero-central disc herniation is seen to indent the thecal sac at the L1-L2 level.
Mild posterior disc bulges are noted at the L2-L3 and L3-L4 levels.
The L4-L5 and L5-S1 facet joints show hypertrophic degenerative changes. The rest of the lumbar facets show hypertrophic changes.
A Schmorls node is noted at the inferior aspect of the L4 vertebral body.
Left far lateral (extraforaminal) disc bulges are noted at the L4-L5 and L5-S1 levels. There is mild ligamentum flavum hypertrophy at these levels.
The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. 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 :
11.0 mm at L1-L2
14.0 mm at L2-L3
15.0 mm at L3-L4
10.0 mm at L4-L5
9.0 mm at L5-S1.
The MRI features are suggestive of :
1. A right paracentral disc extrusion at the L5-S1 level with a disc portion lying within the right lateral recess of the S1 vertebra with impingement of the traversing right S1 nerve root.
2. A large postero-central disc herniation at the L4-L5 level.
3. A postero-central disc herniation at the L1-L2 level.
4. Hypertrophic facetal arthropathy and mild ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels.