sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz B. Thorwalmn / M / 42 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE since 5-6 years which has increased since 2-3 months.
H/O fever since 2-3 months.
H/O loss of appetite since 1 month.

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 normal lumbar lordosis and loss of water content of the lumbar intervertebral discs.

There are small posterior disc bulges with peridiscal osteophytes at the L5-S1, L3-L4 and L1-L2 levels.

A posteriorly herniated disc with peridiscal osteophytes is noted at the L4-L5 level with bilateral neural foraminal narrowing. There is inferior migration of the disc posterior to the L5 vertebra with indentation of the traversing left L5 nerve root.

A left paracentral disc herniation is noted at the L2-L3 level with left neural foraminal narrowing.

Schmorls nodes are noted in the upper lumbar region.


There is transepiphyseal herniation of the L3-L4 and L4-L5 intervertebral discs through the antero-superior margins of the L4 and L5 vertebral bodies (limbus vertebrae).

The facet joints at the L4-L5 and L5-S1 levels appear slightly hypertrophied.

Anterior disc herniations are seen over the L3-L4 and L4-L5 levels.

The lumbar vertebral bodies 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 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
13.0 mm at L2-L3
14.0 mm at L3-L4
12.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. Small posterior disc bulges with peridiscal osteophytes at the L5-S1, L3-L4 and L1-L2 levels.

2. A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing with inferior migration of the disc and indentation of the traversing left L5 nerve root.

3. A left paracentral disc herniation at the L2-L3 level.

4. Facetal hypertrophy at the L4-L5 and L5-S1 levels.