Sunday, 27 December 2015 16:48

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Date : 00.00.00

Name of the Patient : Abc Xyzo Tendulmn / M / 56 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 0000 which is increased since 15 days.

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 L4-L5 and L5-S1 intervertebral discs show loss of water content.

There is slight retrolisthesis of the L5 over the S1 vertebra. A pseudo-posterior disc herniation is seen at the L5-S1 level with anterior indentation of the thecal sac. There is inferior migration of the disc portion posterior to the S1 vertebral body indenting the S1 nerve roots.

There is a posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The L4-L5 facet joints show mild degenerative changes.

A posterior and right postero-lateral disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac and right neural foraminal narrowing.
scan-00009


Far lateral disc bulges are seen at the L2-L3 and L1-L2 levels.

The lumbar vertebral bodies and the remaining 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-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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. Slight retrolisthesis of the L5 over the S1 vertebra.

2. A pseudo-posterior disc herniation at the L5-S1 level with inferior migration of the disc portion, posterior to the S1 vertebral body indenting the S1 nerve roots.

3. A posterior disc herniation at the L4-L5 level with
mild facetal arthropathy at this level.

4. Tight lumbar canal over the L4-L5 and L5-S1 levels.


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