sb/ke/nl/nl
Name of the Patient : Abc Xyzkar Talmn / M / 40 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 RLE and 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 sacralization of the L5 vertebra and the L2 vertebral body is as marked on the film.
There is loss of water content of the D12-L1, L3-L4 and L4-L5 intervertebral discs.
There is a fairly large, posteriorly herniated disc with peridiscal osteophyte at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing right L5 nerve root. A sequestered disc fragment is noted in the right antero-lateral epidural space, along the posterior margin of the L4 vertebral body, indenting the traversing right L4 nerve root.
A small postero-central disc herniation is noted at the L3-L4 level.
A small, left paracentral protruded disc is noted at the D12-L1 level.
The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The 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 :
13.0 mm at D12-L1
13.0 mm at L1-L2
14.0 mm at L2-L3
12.0 mm at L3-L4
9.0 mm at L4-L5
9.0 mm at L5-S1.
IMPRESSION :
1. Sacralization of the L5 vertebra.
2. A fairly large, posteriorly herniated disc with peridiscal osteophyte at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing right L5 nerve root. A sequestered disc fragment is noted in the right antero-lateral epidural space, along the posterior margin of the L4 vertebral body, indenting the traversing right L4 nerve root.
3. A small postero-central disc herniation at the L3-L4 level.
4. A small, left paracentral protruded disc at the D12-L1 level.