Name of the Patient : Abc Xyzdevi Selmn / F / 52 yrs.
Referred by : Dr. Abc Xyzrikh.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE with tingling since 7-8 months.
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 probable sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs. There is loss of water content of the L4-L5 and L5-S1 intervertebral discs.
A small posterior disc herniation with peridiscal osteophytes is noted at the L5-S1 level. Facetal and ligamentum flavum hypertrophy is also noted at this level with canal stenosis.
Posteriorly bulging discs are noted at the L3-L4 and L4-L5 levels with bilateral neural foraminal narrowing, more pronounced at the L4-L5 level. There is also facetal and ligamentum flavum hypertrophy with canal stenosis at the L4-L5 level.
Slight facetal hypertrophy is also noted in the rest of the lumbar region.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
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 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
16.0 mm at L2-L3
12.0 mm at L3-L4
10.0 mm at L4-L5
5.0 mm at L5-S1.
The MRI features are suggestive of :
1. Probable sacralization of the L5 vertebra. Please correlate with plain radiographs.
2. A small posterior disc herniation with peridiscal osteophytes at the L5-S1 level with facetal and ligamentum flavum hypertrophy at this level with canal stenosis.
3. Posteriorly bulging discs at the L3-L4 and L4-L5 levels with facetal and ligamentum flavum hypertrophy at these levels and canal stenosis at the L4-L5 level.
4. Slight facetal hypertrophy in the rest of the lumbar region.
5. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.