Name of the Patient : Abc XyzBhatelmn / M / 75 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with radiation of pain to BLE 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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.
The lumbar intervertebral discs show loss of water content. The lumbar vertebral bodies show areas of fatty replacement of normal marrow.
There is slight forward translation of the L4 over the L5 vertebra and mild retroplacement of the L1 over the L2 vertebra.
A posterior disc herniation with peridiscal osteophytes, more to the right of the midline is seen to indent the thecal sac and narrow both neural foramina with indentation upon the exiting L4 nerve roots at the L4-L5 level. The L4-L5 facet joints show hypertrophic degnerative changes. Ligamentum flavum hypertrophy is noted at the L4-L5 and L5 levels.
A small postero-central disc herniation is seen to indent the thecal sac at the L1-L2 level.
- 2 - Scan-00002
A posterior disc bulge is noted at the L3-L4 level. Bilateral far lateral disc bulges are noted at the L1-L2, L2-L3, L3-L4 and L4-L5 levels.
The L3-L4 and L5-S1 facet joints show degenerative changes. Facetal hypertrophy is noted at the L2-L3 level.
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 :
18.0 mm at L1-L2
17.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
12.0 mm at L5-S1.
The MRI features are suggestive of :
1. Sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.
2. A posterior disc herniation with peridiscal osteophytes, more to the right of the midline at the L4-L5 level.
3. A small postero-central disc herniation at the L1-L2 level.
4. Hypertrophic facetal arthropathy at the L4-L5 level and
ligamentum flavum hypertrophy at the L4-L5 and L5 levels with resultant canal stenosis.
5. Facetal arthropathy at the L3-L4 and L5-S1 levels.