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Name of the Patient : Abc Xyzn V. Palmn / F / 64 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE with paresthesias since 0000.

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, L4-L5 and L5-S1 intervertebral discs. The L5-S1 intervertebral disc shows a hypointense signal on all the pulse sequences suggesting calcium/vacuum phenomena.

There is Grade I to II spondylolisthesis of the L5 over the S1 vertebra without obvious spondylolysis. A resultant, fairly large, pseudo-posterior disc bulge is noted at the L5-S1 level with bilateral neural foraminal narrowing. There is impingement of the exiting right L5 nerve root in the right neural foramen at the L5-S1 level. A probable disc fragment is noted in the right neural foramen at the L5-S1 level. There is also hypertrophic facetal arthropathy and ligamentum flavum hypertrophy with resultant canal stenosis.

A posteriorly bulging disc is noted at the L4-L5 level with slight bilateral neural foraminal narrowing and facetal hypertrophy at this level.



A small, postero-central protruded disc with peridiscal osteophyte is noted at the L3-L4 level.

The lumbar vertebral bodies show spotty fatty marrow changes. 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 L1-L2 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 :

18.0 mm at L1-L2
19.0 mm at L2-L3
17.0 mm at L3-L4
16.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

1. Grade I to II spondylolisthesis of the L5 over the S1 vertebra without obvious spondylolysis.

2. A fairly large, pseudo-posterior disc bulge at the L5-S1 level with impingement of the exiting right L5 nerve root in the right neural foramen at this level. A probable disc fragment is noted in the right neural foramen at the L5-S1 level with hypertrophic facetal arthropathy, ligamentum flavum hypertrophy and resultant canal stenosis at this level.

3. A posteriorly bulging disc at the L4-L5 level with facetal hypertrophy.
..3/.








- 3 - Scan-00002



4. A small, postero-central protruded disc with peridiscal osteophytes at the L3-L4 level.

As compared to the previous MRI (study no.0000) dated 00.00.00 :

1. There is slight increase in the degree of the spondylolisthesis of the L4 over the L5 vertebra.

2. The right L5 nerve root is impinged in the right neural foramen at the L5-S1 level.

3. A small postero-central protruded disc with peridiscal osteophytes is now noted at the L3-L4 level.

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