Name of the Patient : Abc Xyzli lmn / F / 49 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE with occasional 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.
There appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.
There is mild forward translation of the L4 over the L5 vertebra and mild retroplacement of the L3 over the L4 vertebra.
There is loss of water content of the L3-L4, L4-L5 and L5-S1 intervertebral discs.
There is a postero-central and a right postero-lateral disc herniation indenting the thecal sac and narrowing the right neural foramen with indentation upon the exiting right L4 nerve root, respectively at the L4-L5 level. Bilateral far lateral disc herniations are seen to indent the extraforaminal portion of the exiting L4 nerve roots at the L4-L5 level.
The L4-L5 facet joints show hypertrophic degenerative changes.
- 2 - Scan-00009
Ligamentum flavum hypertrophy is noted at the L4-L5 and L5 levels.
There is a postero-central disc protrusion indenting the thecal sac at the L3-L4 level. Mild facetal hypertrophy is noted at this level.
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 uterus appears to be bulky.
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 :
18.0 mm at L1-L2
18.0 mm at L2-L3
14.0 mm at L3-L4
11.0 mm at L4-L5
11.0 mm at L5-S1.
The MRI features are suggestive of :
1. Sacralization of the L5 vertebra.
2. A postero-central and a right postero-lateral disc herniation with indentation upon the exiting right L4 nerve root at the L4-L5 level.
3. Bilateral far lateral disc herniations indenting the extraforaminal portion of the exiting L4 nerve roots at the L4-L5 level.
4. Hypertrophic facetal arthropathy at the L4-L5 level and
ligamentum flavum hypertrophy at the L4-L5 and L5 levels with a tight canal at these levels.