hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzwas Molmn / M / 34 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias in the LUE and LLE since 5 months.
Alleged H/O fall prior to this.

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 Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra. There is a break of the pars interarticularis of the L5 vertebra bilaterally.

There is slight retroplacement of the L1 vertebra over the L2 vertebra. There is anterior wedging of the L1 vertebral body and it shows areas of fatty replacement of the normal marrow. A large Schmorls node is noted at its inferior aspect and a smaller one at its superior aspect.

A posterior disc bulge with peridiscal osteophytes is noted at the L5-S1 level. A left postero-lateral disc herniation with peridiscal osteophytes is seen to narrow the left neural foramen and impinge the foraminal left L5 nerve root at the L5-S1 level. A small disc portion is seen to lie posterior to the L5 vertebra.



A posterior disc bulge with peridiscal osteophytes is seen to indent the thecal sac at the L1-L2 level.

Mild posterior disc bulges with small peridiscal osteophytes are noted at the D12-L1 and L4-L5 levels with resultant indentation upon the thecal sac at these levels.

The D11-D12, D12-L1, L1-L2, L4-L5 and L5-S1 intervertebral discs show loss of water content. The D11-D12, D12-L1 and L1-L2 intervertebral discs are reduced in height.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12 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 :

16.0 mm at L1-L2
17.0 mm at L2-L3
17.0 mm at L3-L4
17.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra with spondylolysis of the L5 vertebra bilaterally.

2. Anterior wedging of the L1 vertebral body with fatty changes
most likely is the result of previous trauma.

3. A left postero-lateral disc herniation with peridiscal osteophytes impinging the foraminal left L5 nerve root at the L5-S1 level.