hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Fernalmn / M / 60 yrs.
Referred by : Dr. Abc Xyznshashi.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 1 year.

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 L4 vertebra over the L5 vertebra. There is suspicious spondylolysis of the L5 vertebra (please correlate with plain radiographs).

A large posterior disc extrusion with peridiscal osteophytes is seen to indent the thecal sac and narrow both neural foramina with impingement of the exiting L4 nerve roots bilaterally at the L4-L5 level. The facet joints at this level show hypertrophic degenerative changes. Also seen is ligamentum flavum hypertrophy at the L4-L5 and L5 levels with canal stenosis.

A large postero-central and left postero-lateral disc extrusion with peridiscal osteophytes is seen to indent the thecal sac and narrow the left neural foramen at the L5-S1 level. There is indentation upon the thecal sac and traversing S1 nerve roots (left more than right) at this level. A small right postero-lateral (foraminal) disc herniation is also noted at this level. The left S1 nerve root appears slightly larger than the right and is ? inflamed.


Small posterior disc herniations with peridiscal osteophytes are seen to indent the thecal sac and cause slight neural foraminal narrowing bilaterally at the L2-L3 and L3-L4 levels. The L2-L3 and L3-L4 facet joints show hypertrophic degenerative changes.

The L1-L2 and L5-S1 facet joints show degenerative changes.

Far lateral disc herniations are seen bilaterally over the L2-L3 to L5-S1 levels. A right far lateral (extraforaminal) disc herniation is seen to indent the exiting right L1 nerve root at the L1-L2 level.

Anterior disc herniations are seen at the L1-L2 and L4-L5 levels.

The lumbar intervertebral discs show loss of water content.

The lumbar vertebral bodies show areas of fatty replacement of normal marrow suggestive of osteoporotic changes.

The pedicles of the lumbar vertebrae appear to be congenitally short in their antero-posterior dimensions.

The conus medullaris terminates at the D12-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
11.0 mm at L3-L4
7.0 mm at L4-L5
5.0 mm at L5-S1.
..3/.












- 3 - Scan-00002

IMPRESSION :

The MRI features are suggestive of :

1. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.

2. A large posterior disc extrusion with peridiscal osteophytes
with hypertrophic facetal arthropathy and ligamentum flavum hypertrophy with canal stenosis at the L4-L5 level.

3. Large postero-central and left postero-lateral disc extrusion with peridiscal osteophytes with canal stenosis
at the L5-S1 level.

4. A small right postero-lateral (foraminal) disc herniation at the L5-S1 level.

5. Bilateral far lateral (extraforaminal) disc herniations over the L2-L3 to L5-S1 levels and on the right side at the L1-L2 level.

6. Small posterior disc herniations with peridiscal osteophytes with hypertrophic facetal arthropathy at the L2-L3 and L3-L4 levels.

7. Facetal arthropathy at the L1-L2 and L5-S1 levels.

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