Name of the Patient : Abc XyzKesllmn / F / 47 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE.
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 Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra with spondylolysis of the L4 vertebra, bilaterally. The L4-L5 intervertebral disc is reduced in height and shows loss of water content.
There is a posterior disc herniation at the L4-L5 level with bilateral neural foraminal narrowing. A superiorly migrated, small sequestered disc fragment is noted in the right lateral epidural space along the inferior margin of the L4 vertebral body, impinging the traversing right L4 nerve root. This nerve root is probably inflamed.
Slight facetal hypertrophy is noted at the L5-S1 level bilaterally. The L4-L5 facet joint shows degenerative changes.
The L2-L3 intervertebral disc shows slight loss of water content.
The lumbar vertebral bodies show spotty fatty marrow changes. 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 S2 level.
Fat is noted in the filum terminale at the L2-L3 and L5-S1 levels.
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
14.0 mm at L3-L4
12.0 mm at L4-L5
11.0 mm at L5-S1.
Screening, T1 Weighted sagittal images of the dorsal spine reveal spotty fatty marrow changes in the visualized dorsal vertebral bodies.
1. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra with spondylolysis of the L4 vertebra, bilaterally.
2. A posterior disc herniation at the L4-L5 level with a superiorly migrated, small sequestered disc fragment in the right lateral epidural space along the inferior margin of the L4 vertebral body, impinging the traversing right L4 nerve root. Facetal arthropathy is noted at the L4-L5 level.
3. Slight facetal hypertrophy at the L5-S1 level bilaterally.