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Name of the Patient : Abc Xyz Dlmn / F / 33 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE with paresthesias.

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 :

The L5 vertebra is as marked on the film.

There is loss of water content of the L4-L5 and L5-S1 intervertebral discs. The L5-S1 intervertebral disc appears reduced in height.

There is a fairly large, left paracentral extruded disc at the L5-S1 level with thecal sac compression. Superior and inferior migration of the disc fragment is noted with indentation of the traversing left L5 and S1 nerve roots, respectively and the thecal sac. The posterior longitudinal ligament-annulus fibrosis complex appears ruptured.

A small, postero-central protruded disc is noted at the L4-L5 level.

Type II degenerative marrow changes are noted in the L5 vertebral body adjacent to the L5-S1 disc.


The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The 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 S2 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
18.0 mm at L2-L3
18.0 mm at L3-L4
15.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. A fairly large, left paracentral extruded disc at the L5-S1 level with superior and inferior migration of the disc fragment indenting the traversing left L5 and S1 nerve roots, respectively with rupture of the posterior longitudinal ligament - annulus fibrosis complex.

2. A small, postero-central protruded disc at the L4-L5 level.


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