ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / M / 30 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O weakness of BLE with bladder involvement since 10-12 days.
Recently diagnosed as having Pulmonary Kochs.

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 L5 vertebra appears to be as marked on the film. Please correlate with plain radiographs.

There is loss of normal lumbar lordosis and mild scoliosis with convexity to the left.

There is a large right postero-central disc herniation with peridiscal osteophytes at the L3-L4 level with compression upon the thecal sac. A sequestered disc fragment is seen to migrate posterior to the L3 vertebral body with resultant canal stenosis and impingement of the traversing L3 nerve roots. A small right postero-lateral disc herniation is seen to narrow the right neural foramen at the L3-L4 level.

Postero-central disc herniations are noted at the L1-L2, L2-L3 and L4-L5 levels with anterior indentation of the thecal sac.



A mild posterior disc bulge is seen at the L5-S1 level.

The lumbar intervertebral discs show loss of water content.

The right L4-L5 facet joint shows hypertrophic degenerative changes. The L1-L2, L2-L3 and L3-L4 facet joints also show degenerative changes.

Bilateral far lateral (extraforaminal) disc bulges are seen at the L3-L4 level.

The pedicles of the lumbar vertebrae are congenitally short in their antero-posterior dimensions.

The lumbar vertebral bodies reveal normal signal intensity. 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.

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

12.0 mm at L1-L2
12.0 mm at L2-L3
8.0 mm at L3-L4
10.0 mm at L4-L5
12.0 mm at L5-S1.

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and the visualized dorsal spine does not reveal any diagnostic feature of note.
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IMPRESSION :

1. A large postero-central disc herniation with peridiscal osteophytes at the L3-L4 level with a sequestered disc fragment migrating posterior to the L3 vertebral body with resultant canal stenosis and impingement of the traversing L3 nerve roots.

2. Postero-central disc herniations at the L1-L2, L2-L3 and L4-L5 levels.

3. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.

4. A small right postero-lateral disc herniation at the L3-L4 level.

5. Hypertrophic facetal arthropathy on the right side at the L4-L5 level and facetal arthropathy at the L1-L2, L2-L3 and L3-L4 levels.