Name of the Patient : Abc XyzShlmn / F / 40 yrs.
Referred by : Dr. Abc Xyz
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with paresthesias since 4-5 months.
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 loss of water content of nearly all the lumbar intervertebral discs except the L5-S1 disc.
A small posterior disc bulge is noted at the L5-S1 level.
A posterior disc herniation is noted at the L4-L5 level with bilateral neural foraminal narrowing, facetal and ligamentum flavum hypertrophy and canal stenosis.
Small posterior disc bulges are noted at the L1-L2, L2-L3 and L3-L4 levels, with bilateral neural foraminal narrowing at the L3-L4 level.
Facetal hypertrophy is noted in the lumbar region more so at the L3-L4, L4-L5 and L5-S1 levels.
Schmorls nodes are noted in the dorso-lumbar region.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
Slight anterior wedging of the D12, L1 and L2 vertebral bodies is noted.
The lumbar vertebral bodies reveal normal signal intensity. 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 :
11.0 mm at L1-L2
10.0 mm at L2-L3
11.0 mm at L3-L4
6.0 mm at L4-L5
7.0 mm at L5-S1.
1. A posterior disc herniation at the L4-L5 level with bilateral neural foraminal narrowing.
2. A small posterior disc bulge at the L5-S1 level.
3. Small posterior disc bulges at the L1-L2, L2-L3 and L3-L4 levels.
4. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.
5. Facetal hypertrophy in the lumbar region more so at the L3-L4, L4-L5 and L5-S1 levels with ligamentum flavum hypertrophy at the L4-L5 level.
6. Lower lumbar canal stenosis, maximum at the L3-L4, L4-L5 and L5-S1 levels.