ke/bv/rg/nl
Name of the Patient : Abc Xyz K. Almaklmn / F / 50 yrs.
Referred by : Dr. Abc Xyz.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
Known C/O multiple sclerosis.
C/O difficulty in walking.
H/O anterior decompression with C5-C6 discectomy.
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 forward subluxation of the L5 over the S1 vertebra with spondylolysis of L5 bilaterally. A pseudoposterior disc bulge is seen at this level.
There is a posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac.
The lower lumbar facet joints show mild degenerative changes.
Small posterior disc bulges are seen at the L3-L4, L2-L3 and L1-L2 levels.
..2/.
- 2 - Scan-00000
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-L2 level and the thecal sac terminates at the S2 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
15.0 mm at L3-L4
13.0 mm at L4-L5
15.0 mm at L5-S1.
IMPRESSION :
1. Grade I spondylolisthesis of L5 over the S1 vertebra with spondylolysis at L5 bilaterally and a pseudoposterior disc bulge at this level.
2. Posterior disc herniation at the L4-L5 level.