Name of the Patient : Abc Xyzn Lakdalmn / F / 57 yrs.
Referred by : Dr. Abc Xyzolakia.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with radiation of pain 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.
The D12-L1, L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.
Small posterior disc herniations are seen to narrow the neural foramina bilaterally at the L4-L5 and L5-S1 levels with slight indentation upon the thecal sac at the L4-L5 level.
A right far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level.
The L4-L5 facet joints show severe hypertrophic degenerative changes with presence of joint effusion. Also seen is facetal hypertrophy with joint effusion at the L3-L4 and L5-S1 levels. Ligamentum flavum hypertrophy is noted at the L4-L5 and L5 levels.
Bilateral far lateral disc bulges are noted at the L3-L4 and L5-S1 levels and on the left side at the L4-L5 level.
Focal hemangiomas are noted in the L5, L2 and L1 vertebral bodies.
The rest of the lumbar vertebral bodies and 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 :
20.0 mm at L1-L2
20.0 mm at L2-L3
20.0 mm at L3-L4
15.0 mm at L4-L5
12.0 mm at L5-S1.
The MRI features are suggestive of :
1. Small posterior disc herniations at the L4-L5 and L5-S1 levels.
2. Severe hypertrophic facetal arthropathy and ligamentum flavum hypertrophy with canal stenosis at the L4-L5 level.
3. A right far lateral (extraforaminal) disc herniation
indenting the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level.