Name of the Patient : Abc Xyzati Plmn / F / 48 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias.

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 (except L1-L2).

There is Grade I spondylolisthesis of the L3 vertebra over the L4 vertebra without obvious spondylolysis. Kindly correlate with plain radiographs. The inferior cortical endplate of the L3 vertebra is irregular with narrowing of the L3-L4 disc space. A limbus vertebra is seen at the L4 vertebral level.

A large diffuse posterior disc herniation with peridiscal osteophytes is seen at the L3-L4 level with anterior compression of the thecal sac and resultant canal stenosis. Bilateral far lateral disc bulges are also seen at this level with bilateral neural foraminal narrowing and indentation on the foraminal and extra-foraminal segments of the L3 nerve roots bilaterally. Hypertrophic facetal arthropathy and ligamentum flavum hypertrophy are also seen at this level, with facet joint effusion on the right side.

A posterior and left postero-lateral disc herniation with peridiscal osteophytes is seen at the L4-L5 level with anterior indentation of the thecal sac, bilateral neural foraminal narrowing and mild indentation on the foraminal and extra-foraminal segment of the exiting left L4 nerve root.

Small posterior disc bulge is seen at the L5-S1 level and small right postero-lateral disc herniation is noted at the L2-L3 level.

Right far-lateral disc bulge is seen at the L4-L5 level and left far-lateral disc bulge is seen at the L2-L3 level.

The lumbar facet joints are also hypertrophied with facet joint effusion at the L3-L4 level on the right side. 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 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 :

15.0 mm at L1-L2
14.0 mm at L2-L3
6.0 mm at L3-L4
12.0 mm at L4-L5
13.0 mm at L5-S1.

A Tarlovs perineurial cyst is seen at the S2 level on the right side.
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- 3 - Scan-00007

IMPRESSION :

1. Grade I spondylolisthesis of the L3 vertebra over the L4 vertebra without obvious spondylolysis, probably traumatic/degenerative.

2. A large diffuse posterior disc herniation with peridiscal osteophytes at the L3-L4 level with bilateral far lateral disc bulges causing bilateral neural foraminal narrowing and indentation on the foraminal and extra-foraminal segments of the L3 nerve roots bilaterally with facetal and ligamentum flavum hypertrophy with resultant canal stenosis.

3. A posterior and left far-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing and mild indentation on the foraminal and extra-foraminal segment of the exiting left L4 nerve root.

4. Hypertrophied lumbar facet joints.