Name of the Patient : Abc Xyzndas M. Panlmn / M / 72 yrs
Referred by : Dr. Abc Xyzhta / Dr. Abc Xyzmani.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with radiation of pain and paresthesias to BLE.
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 is mild retroplacement of the L4 over the L5 and of L5 over the S1 vertebrae.
There is a small posterior disc herniation indenting the thecal sac and narrowing both neural foramina at the L4-L5 level.
There are mild posterior disc bulges at the L2-L3, L3-L4 and L5-S1 levels.
Bilateral far lateral disc bulges are noted over the L2-L3 to L5-S1 levels. Anterior disc herniations with peridiscal osteophytes are seen over the D12-L1 to L4-L5 levels.
The L4-L5 and L5-S1 facet joints show hypertrophic degenerative changes with ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels. The rest of the lumbar facet joints show mild degenerative changes.
There is a probable conjoint nerve root at the L5-S1/S1 levels on the left.
There is slight anterior wedging of the L1 and L2 vertebral bodies. A hemangioma with fat content (hyperintense on all the pulse sequences) is seen indenting the L1 vertebral body. The L2 and L3 vertebral bodies show areas of fatty replacement of normal marrow.
The lumbar intervertebral discs show loss of water content.
The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
The visualized pre and paravertebral soft tissues are unremarkable.
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
15.0 mm at L2-L3
16.0 mm at L3-L4
10.0 mm at L4-L5
12.0 mm at L5-S1.
The MRI features are suggestive of :
1. A small posterior disc herniation at the L4-L5 level.
2. Mild posterior disc bulges at the L2-L3, L3-L4 and L5-S1 levels.
- 3 - Scan-00001
3. Hypertrophic facetal arthropathy with ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels.
4. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.
5. A tight canal at the L4-L5 level.