Name of the Patient : Abc Xyzshdevlmn / F / 55 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the BLE with paresthesias.
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 lower lumbar intervertebral discs show loss of water content.
There is forward translation of the L4 over the L5 vertebral body.
There is a large postero-central and right postero-lateral
disc herniation at the L3-L4 level with anterior indentation of the thecal sac and right neural foraminal narrowing, with canal stenosis.
A diffuse posterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. Facetal hypertrophy and ligamentum flavum hypertrophy is also noted at this level with resultant canal stenosis.
A small postero-central disc protrusion is noted at the L5-S1 level. The right S1 nerve root is of slightly larger calibre than the left and is probably inflamed. Ligamentum flavum hypertrophy is noted at the L5 and L5-S1 levels.
The pedicles of the lower lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
The lumbar facet joints show degenerative changes.
Type II degenerative changes are noted in the L3 vertebral body.
The rest of 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 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 :
17.0 mm at L1-L2
16.0 mm at L2-L3
10.0 mm at L3-L4
4.0 mm at L4-L5
8.0 mm at L5-S1.
The MRI features are suggestive of :
1. A large postero-central and right postero-lateral
disc herniation at the L3-L4 level, with canal stenosis.
2. A diffuse posterior disc herniation at the L4-L5 level with facetal hypertrophy and ligamentum flavum hypertrophy at this level with resultant canal stenosis.
- 3 - Scan-00009
3. A small postero-central disc protrusion at the L5-S1 level with ligamentum flavum hypertrophy at the L5 and L5-S1 levels with probable inflammation of the right S1 nerve root.
4. Congenitally short pedicles of the lower lumbar vertebrae in their antero-posterior dimensions.
5. Facetal arthropathy in the lumbar region.