Name of the Patient : Abc Xyzlmn / M / 40 yrs.
Referred by : Dr. Abc Xyzaveri.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE (right more than left) since 1 year 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 is loss of normal lumbar lordosis. There is slight retroplacement of the L5 vertebra over the S1 vertebra.
The L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content. Type II degenerative changes are seen within the L4, L5 and S1 vertebral bodies. The L5-S1 intervertebral disc is decreased in height.
A large posterior disc extrusion with peridiscal osteophytes is seen to indent the thecal sac and narrow both neural foramina at the L5-S1 level. There is inferior migration of the disc fragment with impingement of both the traversing S1 nerve roots.
A left paracentral disc extrusion is seen to indent the thecal sac at the L4-L5 level.
There is a right paracentral disc herniation indenting the thecal sac at the L3-L4 level.
Small posterior peridiscal osteophytes are noted at the L3-L4 and L4-L5 levels.
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 :
15.0 mm at L1-L2
20.0 mm at L2-L3
17.0 mm at L3-L4
15.0 mm at L4-L5
11.0 mm at L5-S1.
1. A large posterior disc extrusion with peridiscal osteophytes and inferior migration of the disc fragment at the L5-S1 level.
2. A left paracentral disc extrusion at the L4-L5 level.
3. A right paracentral disc herniation at the L3-L4 level.