ke/hs/nl/rg.
Name of the Patient : Abc Xyzlmn / M / 73 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with numbness.
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 :
There is sacralization of the L5 vertebra and the L1 vertebra is as marked on the film. Please correlate with plain radiographs.
There is loss of normal lumbar lordosis.
A large left paracentral disc extrusion with peridiscal osteophytes is seen at the L1-L2 level with compression of the thecal sac and left neural foraminal narrowing. There is inferior migration of the disc into the anterior epidural space at the L2 vertebral level with impingement of the traversing L2 nerve roots (left more than right). A small right postero-lateral disc bulge is also noted at this level. The L1-L2 facet joints show degenerative changes with resultant canal stenosis.
A diffuse posterior disc herniation with peridiscal osteophytes is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. Ligamentum flavum hypertrophy and facetal arthropathy is also seen at this level with a resultant tight canal.
..2/.
Bilateral postero-lateral disc herniations with peridiscal osteophytes are seen to narrow both neural foramen at the L3-L4 level.
Bilateral postero-lateral disc bulges are noted at the L2-L3 level with bilateral neural foraminal narrowing.
Facetal arthropathy is also noted at the L2-L3 and L3-L4
levels.
There is a posteriorly bulging disc and facetal hypertrophy with a resultant tight canal at the D10-D11 level.
Bilateral far lateral disc bulges are seen over the L1-L2 to L5-S1 levels.
There are anterior disc herniations with peridiscal osteophytes at the L1-L2, L2-L3 and L3-L4 levels. The lumbar intervertebral discs show loss of water content.
Type II degenerative change is seen in the antero-superior portion of the L4 vertebral body. The lumbar vertebral bodies show areas of fatty replacement of normal marrow. 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 :
5.0 mm at L1-L2
13.0 mm at L2-L3
12.0 mm at L3-L4
10.0 mm at L4-L5
6.0 mm at L5-S1.
..3/.
- 3 - Scan-00000
IMPRESSION :
1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.
2. A large left paracentral disc extrusion with peridiscal osteophytes at the L1-L2 level with inferior migration of the disc into the anterior epidural space at L2 vertebral level with impingement of the traversing left L2 nerve roots (left more than right). There is facetal arthropathy with resultant tight canal stenosis at this level.
3. A diffuse posterior disc herniation with peridiscal osteophytes at the L4-L5 level with ligamentum flavum hypertrophy and facetal arthropathy with a resultant tight canal.
4. Bilateral postero-lateral disc herniations at the L3-L4 level.
5. Facetal arthropathy at the L2-L3 and L3-L4 levels.
6. A posterior disc bulge and facetal hypertrophy with a tight canal at the D10-D11 level.