Name of the Patient : Abc XyzBhatkhlmn / F / 48 yrs.
Referred by : Dr. Abc Xyzlande / Dr. Abc Xyzhari.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with paresthesias on walking for a long distance since 8 months.
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 L5-S1 intervertebral disc is reduced in height and L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.
There is a posterior and left paracentral disc herniation with posterior peridiscal osteophytes at the L5-S1 level with indentation upon the S1 nerve roots. Bilateral far lateral disc herniations are also noted at this level with indentation upon the extraforaminal portion of the L5 nerve roots.
A diffuse posterior disc herniation is seen at the L4-L5 level with peridiscal osteophytes indenting the anterior aspect of the thecal sac and bilateral neural foraminal narrowing. The L4-L5 facet joints show hypertrophic degenerative changes with facet joint effusion and mild ligamentum flavum hypertrophy and resultant canal stenosis.
There is a small posterior disc bulge and left far lateral (extraforaminal) disc herniation at the L3-L4 level with anterior indentation of the thecal sac and the extraforaminal portion of the traversing left L3 nerve root. The facet joints at this level also show degenerative change.
- 2 - Scan-00008
Anterior disc herniations with peridiscal osteophytes are noted at the L4-L5 and L5-S1 levels.
Type II degenerative changes are seen in the L4, L5 and S1 vertebral bodies adjacent to the L4-L5 and L5-S1 intervertebral discs.
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 :
16.0 mm at L1-L2
15.0 mm at L2-L3
13.0 mm at L3-L4
7.0 mm at L4-L5
9.0 mm at L5-S1.
1. A posterior and left paracentral disc herniation with posterior peridiscal osteophytes at the L5-S1 level indenting the S1 nerve roots with bilateral far lateral disc herniations at this level indenting the extraforaminal portion of the L5 nerve roots.
2. A diffuse posterior disc herniation with peridiscal osteophytes at the L4-L5 level with hypertrophic facetal arthropathy, facet joint effusion and mild ligamentum flavum hypertrophy with resultant canal stenosis at this level.
3. A small posterior disc bulge and left far lateral (extraforaminal) disc herniation at the L3-L4 level indenting the extraforaminal portion of the traversing left L3 nerve root and facetal arthropathy at this level.