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Name of the Patient : Abc Xyzm Naklmn / M / 80 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE since 15 days.

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

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

Large, right postero-lateral and far lateral disc herniation is seen to narrow the right neural foramen and indenting the exiting right L4 nerve root at the L4-L5 level.

Small postero-central disc herniations are seen to indent the thecal sac at the L3-L4 and L4-L5 levels.

Postero-lateral disc herniations are seen bilaterally at the L3-L4 level and on the left side at the L4-L5 level with resultant neural foraminal narrowing at these levels.

A postero-central disc protrusion is noted at the L1-L2 level.
Scan-00005



Far lateral disc bulges are noted bilaterally at the L2-L3 and L3-L4 levels and on the left side at the L4-L5 level.

The L1-L2 to L5-S1 facet joints show hypertrophic degenerative changes. The pedicles of the lower lumbar vertebrae appear congenitally short in their antero-posterior dimensions.

There are probable conjoint nerve root sleeves at the S1 vertebral level.

Anterior disc herniations with peridiscal osteophytes are seen in the lumbar region.

The lumbar intervertebral discs show loss of water content. The lumbar vertebral bodies show areas of fatty replacement of normal marrow which may suggest osteoporosis.

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
18.0 mm at L2-L3
18.0 mm at L3-L4
19.0 mm at L4-L5
20.0 mm at L5-S1.
..3/.











- 3 - Scan-00005


IMPRESSION :

1. Retroplacement of the L4 vertebra over the L5 vertebra.

2. Large, right postero-lateral and far lateral disc herniation indenting the exiting right L4 nerve root at the L4-L5 level.

3. Small postero-central disc herniations at the L3-L4 and L4-L5 levels.

4. Postero-lateral disc herniations bilaterally at the L3-L4 level and on the left side at the L4-L5 level.

5. Hypertropic facetal arthropathy over the L1-L2 to L5-S1 levels.

6. Congenitally short pedicles of the lower lumbar vertebrae in their antero-posterior dimensions.

7. Tight canal at the L3-L4 and L4-L5 levels.
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