Name of the Patient : Abc Xyz R. Motlmn / M / 64 yrs.
Referred by : Dr. Abc Xyzshru.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O radicular pain to the LLE.
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 lumbar intervertebral discs show loss of water content.
A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level, left more than right with indentation upon the exiting L4 and traversing left L5 nerve root.
A mild posterior disc bulge is noted at the L5-S1 level. There are bilateral far lateral disc bulges over the L2-L3 to L5-S1 levels.
The L2-L3 facet joints show severe hypertrophic degenerative changes. The L1-L2 facet joints show degenerative changes.
Facetal hypertrophy is noted at the L3-L4 and L4-L5 levels. Also seen is mild facetal hypertrophy at the L5-S1 level.
The pedicles of the lumbar vertebrae are congenitally short in their antero-posterior dimensions.
The lumbar vertebral bodies show areas of fatty replacement of normal marrow which may suggest osteoporotic changes.
Fat is noted within the filum terminale over the L2 to L4-L5 levels (? normal variant ? fibrolipoma).
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-S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
17.0 mm at L1-L2
16.0 mm at L2-L3
16.0 mm at L3-L4
12.0 mm at L4-L5
13.0 mm at L5-S1.
The MRI features are suggestive of :
1. A posterior disc herniation with a tight canal at the L4-L5 level with indentation upon the traversing L5 and exiting L4 nerve roots.
2. Severe hypertrophic facetal arthropathy at the L2-L3 level with facetal arthropathy at the L1-L2 level.
3. Facetal hypertrophy at the L3-L4 and L4-L5 levels.
4. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.