Name of the Patient : Abc Xyzra Dlmn / M / 48 yrs.
Referred by : Dr. Abc Xyzraf.
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.
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. A small disc portion is seen to lie within the right neural foramen at this level with indentation upon the exiting right L4 nerve root.
There is a small postero-central disc herniation indenting the thecal sac at the L5-S1 level.
A mild posterior disc bulge is noted at the L3-L4 level. Also seen are bilateral far lateral disc bulges at the L3-L4, L4-L5 and L5-S1 levels.
Facetal and ligamentum flavum hypertrophy is seen at the L4-L5 and L5-S1 levels.
The lumbar vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
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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 :
16.0 mm at L1-L2
14.0 mm at L2-L3
14.0 mm at L3-L4
12.0 mm at L4-L5
11.0 mm at L5-S1.
The MRI features are suggestive of :
1. A posterior disc herniation at the L4-L5 level with a disc portion lying within the right neural foramen with indentation upon the exiting right L4 nerve root at this level.
2. A small postero-central disc herniation at the L5-S1 level.
3. Facetal and ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels.