hs/sb/rg/nl
Date : 00.00.00
Name of the Patient : Abc XyzAbdulla Hlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to BLE with paresthesias since 2 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 :
The lumbar intervertebral discs show loss of water content.
A small posterior disc herniation is seen to indent the thecal sac and narrow both the neural foramina at the L4-L5 level. Bilateral far lateral (extraforaminal) disc herniations are noted at this level.
There is a postero-central disc herniation indenting the thecal sac at the D12-L1 level.
Bilateral far lateral (extraforaminal) disc bulges are noted at the L2-L3 and L3-L4 levels.
A mild posterior disc bulge is noted at the L5-S1 level. The right L5-S1 facet joint shows hypertrophic degenerative changes.
Facetal hypertrophy is noted at the L4-L5 level.
Anterior disc herniations with peridiscal osteophytes are seen over the L1-L2 to 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 S1 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
13.0 mm at L4-L5
14.0 mm at L5-S1.
IMPRESSION :
The MRI features are suggestive of :
1. A small posterior disc herniation and bilateral far lateral (extraforaminal) disc herniations
with facetal hypertrophy at the L4-L5 level
2. Postero-central disc herniation at the D12-L1 level.
3. Hypertrophic facetal arthropathy at the L5-S1 level on the right side.