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Name of the Patient : Abc XyzChalmn / F / 50 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE with paresthesias since 2 months.

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 :

The lumbar intervertebral discs show loss of water content.

A posterior disc herniation with peridiscal osteophytes is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level with indentation upon the traversing L5 nerve roots (left more than right). A small disc portion is seen to lie within the left anterior epidural space at the L5 level.

Small posterior disc herniations with peridiscal osteophytes are seen to indent the thecal sac and narrow both neural foramina at the L2-L3 and L3-L4 levels.

There is a small left paracentral disc herniation with peridiscal osteophytes indenting the thecal sac at the L1-L2 level.

There is a posterior disc bulge at the L5-S1 level. Bilateral far lateral disc bulges are noted over the L2-L3 to L5-S1 levels.

Facetal and ligamentum flavum hypertrophy is noted at the L4-L5 and L5-S1 levels with effusion within the L4-L5 facet joints.
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There is mild facetal hypertrophy at the L2-L3 and L3-L4 levels.

Type II degenerative changes are noted within the lumbar vertebral bodies.

Multiple Schmorls nodes are noted in the lumbar region. Anterior disc herniations with peridiscal osteophytes are noted at the L2-L3 and L3-L4 levels.

The L1-L2 facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the 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 :

20.0 mm at D12-L1
18.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
9.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation with peridiscal osteophytes indenting the traversing L5 nerve roots (left more than right) with canal stenosis at the L4-L5 level.

2. Small posterior disc herniations with peridiscal osteophytes at the L2-L3 and L3-L4 levels.

3. A small left paracentral disc herniation with peridiscal osteophytes at the L1-L2 level.

4. Facetal and ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels.

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