Name of the Patient : Abc Xyzta lmn / F / 43 yrs.
Referred by : Dr. Abc Xyztchha.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE 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.
A posterior disc herniation with small peridiscal osteophytes is seen to compress upon the thecal sac at the L4-L5 level with bilateral neural foraminal narrowing at this level. A right far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level.
There is a posterior disc bulge at the L5-S1 level. Right far lateral (extraforaminal) disc bulges are noted at the L2-L3 and L3-L4 levels.
There is ligamentum flavum hypertrophy at the L4-L5 and L5 levels. Facetal hypertrophy is noted at the L3-L4 and L4-L5 levels.
The L4-L5 intervertebral disc shows loss of water content.
The lumbar vertebral bodies and 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 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 :
15.0 mm at L1-L2
14.0 mm at L2-L3
11.0 mm at L3-L4
8.0 mm at L4-L5
9.0 mm at L5-S1.
The MRI features are suggestive of :
1. A posterior disc herniation with small peridiscal osteophytes at the L4-L5 level and ligamentum flavum hypertrophy at the L4-L5 and L5 levels with resultant canal stenosis.
2. A right far lateral (extraforaminal) disc herniation indenting the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level.
3. Facetal hypertrophy at the L3-L4 and L4-L5 levels.