Name of the Patient : Abc XyzSlmn / M / 69 yrs.
Referred by : Dr. Abc Xyzolakia.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE.
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.
There is mild retroplacement of the L5 over the S1 and of the L2 over the L3 vertebrae.
A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. Ligamentum flavum hypetrophy is noted at the L4-L5 and L5 levels.
There is a small posterior disc herniation indenting the thecal sac at the L2-L3 level.
The L4-L5 and L5-S1 facet joints show hypertrophic degenerative changes. Mild facetal hypertrophy is noted at the L1-L2, L2-L3 and L3-L4 levels.
There are posterior disc bulges at the L3-L4 and L5-S1 levels.
There is mild anterior wedging of the D11, D12 and L1 vertebral bodies. The visualized dorso-lumbar vertebral bodies show areas of fatty replacement of normal marrow.
The lumbar intervertebral discs show loss of water content.
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 :
16.0 mm at L1-L2
15.0 mm at L2-L3
15.0 mm at L3-L4
13.0 mm at L4-L5
15.0 mm at L5-S1.
The MRI features are suggestive of :
1. A posterior disc herniation at the L4-L5 level and ligamentum flavum hypertrophy at the L4-L5 and L5 levels with a resultant tight canal.
2. A small posterior disc herniation at the L2-L3 level.
3. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels.