Name of the Patient : Abc Xyzh Glmn / M / 33 yrs.
Referred by : Dr. Abc Xyzh Savardekar /
Dr. Abc Xyz
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O right sided sciatica.
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 L4-L5 intervertebral disc shows loss of water content.
There is evidence of a right paracentral disc herniation with small peridiscal osteophytes indenting the thecal sac at the L4-L5 level. A disc portion is seen to lie within the right lateral recess of the L5 vertebra with resultant impingement of the traversing right L5 nerve root.
Facetal hypertrophy is noted at the L2-L3, L3-L4 and L4-L5 levels.
There is ligamentum flavum hypertrophy at the L4-L5 level.
Fat is noted along the filum terminale over the L1 to L4 vertebral levels (? normal variant, ? small fibrolipoma).
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 :
19.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
12.0 mm at L4-L5
10.0 mm at L5-S1.
Screening T1 Weighted coronal images of the sacro-iliac joints do not reveal any significant feature of note.
The MRI features are suggestive of a right paracentral disc herniation with small peridiscal osteophytes and ligamentum flavum hypertrophy with resultant tight lumbar canal at the L4-L5 level with a disc portion seen to lie within the right lateral recess of the L5 vertebra with resultant impingement of the traversing right L5 nerve root.