sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzakant Cholmn / M / 67 yrs.
Referred by : Dr. Abc Xyzthwani.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache.

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 reduction in height of the L2-L3 and L3-L4 intervertebral discs and loss of water content of the lumbar intervertebral discs. There is mild retroplacement of the L3 over the L4, L4 over the L5 and L5 over the S1 vertebrae.

There is a posterior and left postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with left neural foraminal narrowing and indentation of the foraminal segment of the left L5 nerve root. Slight facetal and ligamentum flavum hypertrophy is noted at this level, more so on the left side. A left far lateral (extraforaminal) disc herniation is also seen at this level.

A posterior and bilateral far lateral (extraforaminal) disc herniation with peridiscal osteophytes is noted at the L4-L5 level with bilateral neural foraminal narrowing. Facetal hypertrophy is noted at this level.

Bilateral postero-lateral and far lateral disc herniations with peridiscal osteophytes are noted at the L3-L4 level with bilateral neural foraminal narrowing.

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A left far lateral (extraforaminal) disc bulge with peridiscal osteophytes is noted at the L2-L3 level.

Anterior disc herniations with peridiscal osteophytes are noted in the lumbar region.

The L3 and L4 vertebral bodies adjacent to the L3-L4 intervertebral disc appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. There is slight irregularity of the adjacent cortical endplates.

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 S2 level.

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

18.0 mm at L1-L2
16.0 mm at L2-L3
12.0 mm at L3-L4
9.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. A posterior and left postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with left neural foraminal narrowing and indentation of the foraminal segment of the left L5 nerve root. Slight facetal and ligamentum flavum hypertrophy is noted at this level, more so on the left side. Also seen is a left far lateral (extraforaminal) disc herniation at this level.

2. A posterior and bilateral far lateral disc herniations with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing.
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3. Bilateral postero-lateral and far lateral (extraforaminal) disc herniations with peridiscal osteophytes at the L3-L4 level with bilateral neural foraminal narrowing.

4. A left far lateral (extraforaminal) disc bulge with peridiscal osteophytes at the L2-L3 level.

5. Altered signal in the L3 and L4 vertebral bodies adjacent to the L3-L4 intervertebral disc most likely represents Type I degenerative marrow changes (bone edema) rather than osteitis.


6. Facetal hypertrophy at the L4-L5 level.

7. A tight canal at the L4-L5 and L5-S1 levels.