ke/sb/rg/nl
Date : 00.00.00
Name of the Patient : Abc XyzKhanvilmn / M / 70 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to BLE (left more than right) with paresthesias since 7-8 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 a left postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with antero-lateral compression of the thecal sac and bilateral neural foraminal narrowing, left more than right. Mild ligamentum flavum and facetal hypertrophy is seen at this level with resultant canal stenosis.
Left and right postero-lateral disc herniations with peridiscal osteophytes are seen at the L2-L3 and L3-L4 levels with bilateral neural foraminal narrowing. The L2-L3 facet joints show mild degenerative changes.
Schmorls nodes are noted in the inferior aspect of the L2 and L3 vertebral bodies and the superior aspect of the L5 vertebral body. Anterior disc herniations with peridiscal osteophytes are seen at the L2-L3, L3-L4 and L4-L5 levels. The lumbar intervertebral discs show loss of water content.
Type II degenerative changes are noted in the lower lumbar vertebrae.
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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 D12 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 :
16.0 mm at L1-L2
15.0 mm at L2-L3
12.0 mm at L3-L4
9.0 mm at L4-L5
11.0 mm at L5-S1.
IMPRESSION :
The MRI features are suggestive of :
1. A left postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with mild ligamentum flavum and facetal hypertrophy and resultant canal stenosis.
2. Bilateral postero-lateral disc herniations with peridiscal osteophytes at the L2-L3 and L3-L4 levels with mild facetal arthropathy at the L2-L3 level.