Name of the Patient : Abc Xyz Hlmn / F / 75 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE.
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 scoliosis of the lumbar spine with convexity to the right side. Also seen is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.
A pseudoposterior disc herniation with slight bilateral neural foraminal narrowing is seen at the L4-L5 level.
The L4-L5 and L5-S1 facet joints (right more than left), show hypertrophic degenerative changes. Ligamentum flavum hypertrophy is noted at the L4-L5 and L5 levels.
Posterior disc bulges are noted at the L2-L3, L3-L4 and L5-S1 levels. There are far lateral disc bulges, bilaterally at the L4-L5 and L5-S1 levels and on the right side at the L2-L3 and L3-L4 levels.
Small posterior peridiscal osteophytes are seen at the L2-L3, L3-L4 and L4-L5 levels. Anterior disc herniations with peridiscal osteophytes are also seen at these levels.
The L1-L2, L2-L3 and L3-L4 facet joints show mild degenerative changes.
The lumbar intervertebral discs show loss of water content. The lumbar vertebrae show areas of fatty replacement of normal marrow which may suggest osteoporotic changes.
The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 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 :
19.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
12.0 mm at L4-L5
14.0 mm at L5-S1.
The MRI features are suggestive of :
1. Grade I spondylolisthesis of the L4 over the L5 vertebra.
2. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels, bilaterally, right more than left, with ligamentum flavum hypertrophy at the L4-L5 and L5 levels and canal stenosis at the L4-L5 level.
3. A pseudoposterior disc herniation at the L4-L5 level.