Name of the Patient : Abc Xyznti Plmn / F / 40 yrs.
Referred by : Dr. Abc XyzGawhale.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE with paresthesias.
H/O radicular pain to the RLE, 1 year back.
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.
The L2-L3 and L4-L5 intervertebral discs show loss of water content.
There is a large postero-central disc herniation at the L4-L5 level with anterior compression of the thecal sac and bilateral neural foraminal narrowing. Inferior migration of the disc is noted indenting the L5 nerve roots bilaterally. The L4-L5 facet joints show hypertrophic degenerative changes.
A postero-central disc herniation with peridiscal osteophytes is seen at the L2-L3 level with anterior indentation of the thecal sac.
Schmorls nodes are noted in the dorso-lumbar region.
The lumbar facet joints show degenerative changes.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
Anterior peridiscal osteophytes are seen in the lumbar region.
Type II degenerative changes are seen at the L4 vertebral body adjacent to the L3-L4 intervertebral disc.
The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1-L2 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 :
15.0 mm at D12-L1
16.0 mm at L1-L2
7.0 mm at L2-L3
13.0 mm at L3-L4
8.0 mm at L4-L5
8.0 mm at L5-S1.
1. A large postero-central disc herniation at the L4-L5 level with inferior migration of the disc indenting the L5 nerve roots bilaterally with the L4-L5 facet joints showing hypertrophic degenerative changes.
2. A postero-central disc herniation with peridiscal osteophytes at the L2-L3 level.
3. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.