sb/hs/nl/rg.
Name of the Patient : Abc Xyzm Plmn / M / 66 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE.
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 loss of water content of the lumbar intervertebral discs and reduction in height of the L2-L3, L3-L4 and L4-L5 intervertebral discs.
There is minimal forward translation of the L4 vertebra over the L5 vertebra with probable spondylolysis of the L4 vertebra on the right. Please correlate with plain radiographs.
There is a small, posterior disc herniation at the L5-S1 level with slight facetal and ligamentum flavum hypertrophy at this level.
A posteriorly herniated disc with peridiscal osteophytes is noted at the L4-L5 level with bilateral neural foraminal narrowing. Hypertrophic facetal arthropathy and ligamentum flavum hypertrophy is also noted at this level with canal stenosis. There is impingement of the exiting L4 nerve roots bilaterally.
Posterior disc herniations with peridiscal osteophytes are noted at the L2-L3 and L3-L4 levels with bilateral neural foraminal narrowing. Slight facetal hypertrophy is also noted at these levels.
..2/.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
Bilateral far lateral disc herniations are noted at the L2-L3, L3-L4 and L4-L5 levels. Bilateral postero-lateral (foraminal) disc bulges are seen at the L1-L2 level.
Schmorls nodes are noted in the dorso-lumbar region.
The lumbar vertebral bodies show spotty fatty marrow changes. The visualized pre and paravertebral soft tissues are unremarkable.
The sacral vertebrae appear ankylosed.
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 :
14.0 mm at D12-L1
14.0 mm at L1-L2
9.0 mm at L2-L3
11.0 mm at L3-L4
7.0 mm at L4-L5
8.0 mm at L5-S1.
Incidentally noted is a cortical renal cyst at the inferior pole of the right kidney.
IMPRESSION :
1. Minimal forward translation of the L4 vertebra over the L5 vertebra with probable spondylolysis of the L4 vertebra on the right. Please correlate with plain radiographs.
2. A small, posterior disc herniation at the L5-S1 level with slight facetal and ligamentum flavum hypertrophy.
..3/.
- 3 - Scan-00009
3. A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing, hypertrophic facetal arthropathy and ligamentum flavum hypertrophy and canal stenosis.
4. Posterior disc herniations peridiscal osteophytes at the L2-L3 and L3-L4 levels with bilateral neural foraminal narrowing and slight facetal hypertrophy at these levels.
5. Tight lumbar canal at the L2-L3, L3-L4 and L5-S1 levels.
6. Congenitally short pedicles of the lumbar vertebrae appear in their antero-posterior dimensions.