ke/bv
Date : 00.00.00

Name of the Patient : Abc XyzM. Galmn / F / 45 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE 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 :

There is sacralization of the L5 vertebra and the L1 vertebral body is as marked on the film.

There is Grade II spondylolisthesis of the L4 over the L5 vertebra with bilateral spondylolysis. A pseudo-posterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. There is indentation upon the foraminal portion of the L4 nerve roots bilaterally. This disc shows loss of water content.

Type II degenerative changes are noted in the L4 and L5 vertebral bodies adjacent to the L4-L5 intervertebral disc.

A probable conjoint nerve root is identified on the right side at the S1 vertebral level.





The rest of 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 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 :

15.0 mm at L1-L2
14.0 mm at L2-L3
13.0 mm at L3-L4
14.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. Grade II spondylolisthesis of the L4 over the L5 vertebra with bilateral spondylolysis and a pseudo-posterior disc herniation at this level indenting the foraminal portion of the L4 nerve roots bilaterally.