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Name of the Patient : Abc Xyziv Harlmn / M / 41 yrs.
Referred by : Dr. Abc Xyzr Patil.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE (right more than left) with paresthesias.

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 loss of water content of the L3-L4 and L5-S1 intervertebral discs. There is minimal forward translation of the L5 over the S1 vertebra without obvious spondylolysis.

There is a fairly large, right postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with right neural foraminal narrowing and indentation on the traversing right S1 nerve root. Slight superior migration of the disc fragment is also noted into the right neural foramen at the L5-S1 level with indentation on the exiting right L5 nerve root.

A small posterior disc bulge is noted at the L4-L5 level.

A fairly large, posteriorly herniated disc with peridiscal osteophyte is noted at the L3-L4 level with thecal sac compression.



Facetal hypertrophy is noted in the lumbar region.

Schmorls nodes are noted in the lumbar region.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. 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 :

15.0 mm at L1-L2
13.0 mm at L2-L3
10.0 mm at L3-L4
11.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. Minimal forward translation of the L5 over the S1 vertebra without obvious spondylolysis.

2. A fairly large, right postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with indentation on the traversing right S1 nerve root. Slight superior migration of the disc fragment is noted indenting the exiting right L5 nerve root.

3. A small posterior disc bulge at the L4-L5 level.

4. A fairly large, posteriorly herniated disc with peridiscal osteophyte at the L3-L4 level.

5. Facetal hypertrophy in the lumbar region.

6. Canal stenosis at the L3-L4 and L5-S1 levels.

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