Name of the Patient : Abc Xyz Khatalmn / M / 31 yrs.
Referred by : Dr. Abc Xyzhari.
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 sacralization of the L5 vertebral body and the L2 vertebra is as marked on the film.

A posterior and right far lateral (extraforaminal) disc bulge is seen at the L4-L5 level with anterior indentation of the thecal sac and mild lateral displacement of the extraforaminal portion of the exiting right L4 nerve root. The L4-L5 facet joints are hypertrophied.

The lumbar vertebral bodies and the 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.




There is an intermediate signal located at the L5-S1 level bilaterally posterior to the disc. This turns hyperintense on the T2 Weighted images with a hypointense area in the centre. This may represent a nerve root with a conjoint nerve root sleeve or an inflamed nerve root (Scans 104.1, 105.1, 104.2, 105.2).

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

16.0 mm at L1-L2
16.0 mm at L2-L3
14.0 mm at L3-L4
10.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebral body.

2. A posterior and right far lateral (extraforaminal)
disc bulge at the L4-L5 level with mild lateral displacement of the extraforaminal portion of the exiting right L4 nerve root.