sb/sb/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzji J. Plmn / M / 49 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to the RLE with tingling since 6-7 months.
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 L4-L5 intervertebral disc.
There is a posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing. There is facetal hypertrophy with resultant canal stenosis at this level.
A minimal posterior disc bulge is noted at the L3-L4 level.
The facet joints at the L5-S1 level show mild degenerative changes bilaterally.
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 level and the thecal sac terminates at the S1 level.
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The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
17.0 mm at L1-L2
21.0 mm at L2-L3
16.0 mm at L3-L4
11.0 mm at L4-L5
13.0 mm at L5-S1.
IMPRESSION :
A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with facetal hypertrophy and resultant canal stenosis at this level.