Name of the Patient : Abc Xyzn Plmn / F / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating 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 is slight scoliosis of the lumbar spine with convexity to the left.
There is loss of water content of the L3-L4 and L4-L5 intervertebral discs.
There is a postero-central and right paracentral disc herniation with peridiscal osteophytes at the L4-L5 level with thecal sac compression and indentation on the traversing right L5 nerve root.
A posteriorly herniated disc is noted at the L3-L4 level with bilateral neural foraminal narrowing and indentation on the traversing L4 nerve roots bilaterally.
Bilateral far lateral disc bulges are noted at the L3-L4, L4-L5 and L5-S1 levels.
Slight facetal hypertrophy is noted at the L3-L4 and L4-L5 levels.
The lumbar vertebral bodies show spotty fatty marrow changes.
The remaining intervertebral discs reveal normal signal intensity. The rest of 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 S1 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
13.0 mm at L1-L2
14.0 mm at L2-L3
12.0 mm at L3-L4
8.0 mm at L4-L5
10.0 mm at L5-S1.
1. A postero-central and right paracentral disc herniation with peridiscal osteophytes at the L4-L5 level indenting the traversing right L5 nerve root.
2. A posteriorly herniated disc at the L3-L4 level with indentation on the traversing L4 nerve roots bilaterally.
3. Slight facetal hypertrophy at the L3-L4 and L4-L5 levels.
4. Canal stenosis at the L4-L5 level and a tight canal at the L3-L4 level.