Name of the Patient : Abc Xyza A. Dlmn / F / 45 yrs.
Referred by : Dr. Abc Xyztchha.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE (right more than left) 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.
There is sacralization of the L5 vertebral body and the L1 vertebra is as marked on the film.
Slight retroplacement of the L4 over the L5 vertebra is seen with a large posterior disc herniation with peridiscal osteophytes at the L4-L5 level causing anterior compression of the thecal sac and bilateral neural foraminal narrowing. Slight inferior migration of the disc is noted indenting the right L5 nerve root. There is ligamentum flavum and facetal hypertrophy at the L4-L5 and L5 levels.
Small posterior and right postero-lateral disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac. The L3-L4 facet joints show hypertrophic degenerative changes.
The L2-L3 and the D10-D11 facet joints also appear slightly hypertrophied.
A hemangioma with fatty content is noted in the L2 and L4 vertebral bodies.
Spotty fatty marrow changes are noted in the lumbar vertebrae.
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 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
16.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
8.0 mm at L5-S1.
Incidentally noted is a cortical renal cyst in the midsegment of the left kidney, anteriorly.
1. Sacralization of the L5 vertebral body.
2. Slight retroplacement of the L4 over the L5 vertebra with a large posterior disc herniation with peridiscal osteophytes at the L4-L5 level with slight inferior migration of the disc indenting the right L5 nerve root.
3. Small posterior and right postero-lateral disc herniation at the L3-L4 level.
4. Facetal hypertrophy at the D10-D11, L2-L3, L3-L4 and L4-L5 levels.