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hs/bv/nl/rg.

Name of the Patient : Abc Xyzeo Waghlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE 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 :

The L1-L2, L2-L3 and L4-L5 intervertebral discs show loss of water content.

There is a large posterior disc herniation with peridiscal osteophytes compressing the thecal sac and narrowing both neural foramina at the L4-L5 level. Bilateral far lateral disc herniations are seen to indent the extraforaminal portion of both the exiting L4 nerve roots at this level. Ligamentum flavum hypertrophy is noted at the L4-L5 and L5 levels with resultant canal stenosis.

Postero-central disc herniations are seen to indent the thecal sac at the L1-L2 and L2-L3 levels.

Posterior disc bulges are seen to indent the thecal sac and narrow both neural foramina at the L3-L4 and L5-S1 levels.

Right far lateral disc herniations are seen to indent the extraforaminal portion of the exiting right L5 and L2 nerve roots at the L5-S1 and L2-L3 levels respectively. There are bilateral far lateral disc bulges at the L3-L4 level and on the left side at the L5-S1 level.
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The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.

Facetal hypertrophy is noted at the L2-L3, L4-L5 and L5-S1 levels.

The lumbar vertebral bodies show areas of fatty replacement of normal marrow. The remaining 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-S2 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

13.0 mm at L1-L2
12.0 mm at L2-L3
12.0 mm at L3-L4
8.0 mm at L4-L5
12.0 mm at L5-S1.

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and does not show any significant feature of note.

IMPRESSION :

1. A large posterior disc herniation with peridiscal osteophytes at the L4-L5 level with ligamentum flavum hypertrophy at the L4-L5 and L5 levels with resultant canal stenosis.

2. Postero-central disc herniations at the L1-L2 and L2-L3 levels.

3. Right far lateral disc herniations indenting the extraforaminal portion of the exiting right L5 and L2 nerve roots at the L5-S1 and L2-L3 levels respectively.
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4. Facetal hypertrophy at the L2-L3, L4-L5 and L5-S1 levels.

5. Congenitally short pedicles of the lumbar vertebral bodies in their antero-posterior dimensions.

6. Tight canal at the L1-L2 and L2-L3 levels.

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