Name of the Patient : Abc XyzI.H. Al-rlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE with paresthesias.
Alleged H/O fall.
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 wedging of the L1 and L2 vertebral bodies with replacement of the normal marrow by hyperintense areas on the T1 Weighted images and is seen to follow fat signal intensity characteristics on all the pulse sequences.
There is a posterior and left lateral disc herniation at the L5-S1 level with anterior indentation of the thecal sac and left neural foraminal narrowing.
Small bilateral far lateral disc bulges are seen at the L3-L4 and L4-L5 levels and a posterior disc herniation is seen at the L2-L3 level.
A posterior disc bulge with peridiscal osteophytes is seen at the L1-L2 level indenting the ventral aspect of the thecal sac. The L1-L2 intervertebral disc shows hyperintense signal on the T2 Weighted images and may represent calcification. The L2 vertebral body also shows an osteophyte at the postero-superior aspect with ventral indentation of the thecal sac.
The lumbar facet joints show degenerative changes.
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Schmorls nodes are seen in the lower dorsal region.
The rest of the lumbar vertebral bodies and the 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 S1 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
16.0 mm at L1-L2
20.0 mm at L2-L3
19.0 mm at L3-L4
17.0 mm at L4-L5
16.0 mm at L5-S1.
The dorsal spine was screened with the help of 5 mm thick T1 Weighted sagittal images which shows slight anterior wedging of the lower dorsal vertebral bodies with fatty changes.
The MRI features are suggestive of :
1. Wedging of the L1 and L2 vertebral bodies with fatty changes may be the sequelae of previous trauma.
2. A posterior disc bulge with peridiscal osteophytes at the L1-L2 level.
3. A posterior and left lateral disc herniation at the L5-S1 level.
4. A posterior disc herniation at the L2-L3 level.
5. Small bilateral far lateral disc bulges at the L3-L4 and L4-L5 levels.
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6. Facetal arthropathy in the lumbar region.
As compared to the previous MRI dated August 0000, there is no significant change noted.