sb/hs/rg.
Name of the Patient : Abc Xyz Khanwalmn / F / 64 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE.
EXAMINATION :
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.
OBSERVATION :
There is scoliosis of the lumbar spine with convexity to the left.
There is loss of water content of the lumbar intervertebral discs with reduction in height of the L2-L3 and L5-S1 intervertebral discs. Some of the lumbar intervertebral discs show evidence of calcium/vacuum phenomena.
There is probable spondylolysis of the L5 vertebra bilaterally. Please correlate with plain radiographs.
There is a posterior disc herniation, more to the right of the midline at the L5-S1 level with inferior migration of the disc fragment indenting the traversing right S1 nerve root. Bilateral far lateral disc bulges are also noted at this level. Also seen is bilateral neural foraminal narrowing with impingement of the exiting L5 nerve roots at the L5-S1 level.
There is a posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing. A left far lateral disc herniation is noted at this level indenting the extraforaminal segment of the exiting left L4 nerve root. A right far lateral disc bulge is noted at this level.
..2/.
>
A left paracentral disc herniation and left and right postero-lateral and far lateral disc herniations are noted at the L3-L4 level with bilateral neural foraminal narrowing and indentation upon the traversing L4 nerve roots and the extraforaminal segments of the exiting L3 nerve roots bilaterally.
Left and right postero-lateral and far lateral disc herniations are noted at the L2-L3 level with bilateral neural foraminal narrowing and indentation upon the extraforaminal segments of the exiting L2 nerve roots bilaterally.
A small postero-central and left postero-lateral disc herniation are noted at the L1-L2 level.
Anterior disc herniations with anterior peridiscal osteophytes and posterior peridiscal osteophytes are noted in the lumbar region.
Facetal and ligamentum flavum hypertrophy is noted at the L3-L4, L4-L5 and L5-S1 levels.
The lumbar vertebral bodies show spotty fatty marrow changes. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The paraspinal muscles in the lumbar region appear atrophied.
The conus medullaris terminates at the L1-L2 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 :
15.0 mm at L1-L2
16.0 mm at L2-L3
16.0 mm at L3-L4
15.0 mm at L4-L5
14.0 mm at L5-S1.
..3/.
- 3 - Scan-00007
IMPRESSION :
1. Scoliosis of the lumbar spine with convexity to the left.
2. Probable spondylolysis of the L5 vertebra bilaterally.
3. A posterior disc herniation, more to the right of the midline at the L5-S1 level with inferior migration of the disc fragment indenting the traversing right S1 nerve root. Also seen is bilateral neural foraminal narrowing with impingement of the exiting L5 nerve roots at the L5-S1 level.
4. A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing with a left far lateral disc herniation at this level indenting the extraforaminal segment of the exiting left L4 nerve root.
5. A left paracentral disc herniation and left and right postero-lateral and far lateral disc herniations at the L3-L4 level with bilateral neural foraminal narrowing and indentation upon the traversing L4 nerve roots and the extraforaminal segments of the exiting L3 nerve roots bilaterally.
6. Left and right postero-lateral and far lateral disc herniations at the L2-L3 level with bilateral neural foraminal narrowing and indentation upon the extraforaminal segments of the exiting L2 nerve roots bilaterally.
7. A small postero-central and left postero-lateral disc herniation at the L1-L2 level.
8. Facetal and ligamentum flavum hypertrophy at the L3-L4, L4-L5 and L5-S1 levels.
9. Tight lumbar canal at the L3-L4, L4-L5 and L5-S1 levels.