Date : 00.00.00

Name of the Patient : Abc Xyzani K. Kablmn / F / 60 yrs.
Referred by : Dr. Abc Xyzdhwa.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 4 months.
H/O fall 2 years back.

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 anterior wedging of the D12, L1 and L3 vertebral bodies with angular kyphus at the D12-L1 level. Herniation of the adjacent intervertebral discs into the bodies of these vertebrae is noted.

There is replacement of the normal marrow of the D12 and L1 vertebral bodies
by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images.

Posterior disc bulges are seen at the L3-L4 and L4-L5 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The facet joints at these levels also show degenerative changes. A small, postero-central protruded disc is noted at the L5-S1 level.

The D11-D12 facet joints show gross hypertrophic degenerative changes with resultant
canal stenosis. The dorsal spinal cord at thsi level shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.

The lumbar intervertebral discs show loss of water content.

The visualized dorso-lumbar vertebral bodies show diffuse fatty changes suggestive of osteoporosis.

The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
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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 :

17.0 mm at L1-L2

14.0 mm at L2-L3

13.0 mm at L3-L4

13.0 mm at L4-L5

10.0 mm at L5-S1.

The upper dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and which does not reveal any significant feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. Anterior wedging of the D12, L1 and L3 vertebral bodies with angular kyphus at the D12-L1 level, may be the sequelae of previous trauma.

2. Altered signal in the D12 and L1 vertebral bodies would represent bone edema.

3. Posterior disc bulges at the L3-L4 and L4-L5 levels with facetal arthropathy
at these levels.

4. Hypertrophic facetal arthropathy at the D11-D12 level with resultant canal stenosis and cord compression. Altered cord signal at the D11-D12 level, suggests cord edema/ischemia.