sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz. Mhlmn / F / 52 yrs.w
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE since paresthesias since 1 1/2 years.
Alleged H/O fall 2 years back.

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 vertebra and which is as marked on the film.

There is loss of water content of all the lumbar intervertebral discs except the L5-S1 disc.

There is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra without obvious spondylolysis. A posterior disc herniation is noted at the L4-L5 level with thecal sac compression. There is also severe hypertrophic facetal arthropathy and ligamentum flavum hypertrophy and resultant lateral recess and central canal stenosis at the L4-L5 level. Also seen is bilateral neural foraminal narrowing at this level.

A posterior disc bulge is noted at the L3-L4 level. The facet joints at this level show hypertrophic degenerative changes.

Bilateral far lateral (extraforaminal) disc herniatins are seen at the L3-L4 and L4-L5 levels. ..2/.






A minimal posterior disc bulge is noted at the L2-L3 level.

Hemangiomas with fat content (hyperintense on all pulse sequences) are noted in the L2 and L4 vertebral bodies.

The rest of the lumbar vertebral bodies reveal normal signal intensity. The remaining 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.

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

14.0 mm at L1-L2
14.0 mm at L2-L3
13.0 mm at L3-L4
8.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra without obvious spondylolysis.

3. A posterior disc herniation at the L4-L5 level with severe hypertrophic facetal arthropathy and ligamentum flavum hypertrophy and resultant lateral recess and central canal stenosis at this level.

4. A posterior disc bulge at the L3-L4 level with hypertrophic facetal arthropathy at this level.