Name of the Patient : Abc XyzVlmn / M / 56 yrs.
Referred by : Dr. Abc Xyzvat.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with progressive weakness of all four extremities.
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 :
The L5 vertebra is as marked on the film. Kindly correlate with plain radiographs.
There is mild retroplacement of the L1 over L2, L2 over L3, L3 over L4 and L4 over L5 vertebrae.
The lumbar intervertebral discs show loss of water content.
There are posterior disc herninations with peridiscal osteophytes indenting the thecal sac and narrowing both neural foramina at the L3-L4 and L4-L5 levels. There is inferior migration of these discs with resultant indentation upon the traversing nerve roots at these levels.
There are right postero-lateral and right far lateral disc herniations mildly narrowing the right neural foramen at the L2-L3 level.
A mild posterior disc bulge is seen at the L5-S1 level.
Far lateral disc bulges are seen bilaterally in the rest of the lumbar region.
There is slight facetal hypertrophy at the L2-L3, L3-L4 and L4-L5 levels.
There is ligamentum flavum hypertrophy with resultant canal stenosis at the L4-L5 and L5 levels. Mild ligamentum flavum hypertrophy is also seen in the rest of the lumbar region.
The pedicles of the lumbar vertebrae appears to be congenitally short in their antero-posterior dimensions.
The lumbar vertebral bodies reveal Type II degenerative/fatty marrow changes.
The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1-L2 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
12.0 mm at L2-L3
11.0 mm at L3-L4
9.0 mm at L4-L5
10.0 mm at L5-S1.
..3/.
- 3 - Scan-00008
IMPRESSION :
The MRI features are suggestive of :
1. Posterior disc herninations with peridiscal osteophytes at the L3-L4 and L4-L5 levels with inferior migration of these discs.
2. Right postero-lateral and right far lateral disc herniations at the L2-L3 level.
3. A mild posterior disc bulge at the L5-S1 level.
4. Slight facetal hypertrophy at the L2-L3, L3-L4 and L4-L5 levels.
5. Ligamentum flavum hypertrophy with canal stenosis at the L4-L5 and L5 levels.
6. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.