MedMantra.com https://www.medmantra.com Sat, 02 Nov 2024 14:37:18 +0000 en-gb 11497 https://www.medmantra.com/item/272-11497 https://www.medmantra.com/item/272-11497 Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 52 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 4 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 a diffuse posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. There is mild indentation on the foraminal portion of the exiting L4 nerve roots. Bilateral far lateral (extraforaminal) disc herniations are also noted at this level, left more than right with mild indentation on the extraforaminal portion of the left exiting L4 nerve root. The L4-L5 facet joints show mild degenerative changes.

There is a left postero-lateral and left far lateral (extraforaminal) disc herniation at the L3-L4 level with left neural foraminal narrowing and indentation on the foraminal and extraforaminal portion of the exiting left L3 nerve root. A right far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting right L3 nerve root at this level.

There appears to be a lesion which is isointense to fat in the posterior epidural space at the L4 and L5 vertebral levels with slight remodelling of the posterior appendages of the L4 and L5 vertebrae. This may represent an epidural lipoma/epidural lipomatosis.

Schmorls node is seen in the superior aspect of the L1 vertebral body. The L3-L4 and L4-L5 intervertebral discs show loss of water content.

The lumbar vertebral bodies and the remaining intervertebral discs show normal signal intensity. 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-L2 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

15.0 mm at L2-L3

15.0 mm at L3-L4

16.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A diffuse posterior disc herniation at the L4-L5 level with mild indentation on the foraminal portion of the exiting L4 nerve roots.

2. Bilateral far lateral (extraforaminal) disc herniations at the L4-L5 level, left more than right with mild indentation on the extraforaminal portion of the exiting left L4 nerve root and mild facetal arthropathy at this level.

3. A left postero-lateral and left far lateral (extraforaminal) disc herniation at the L3-L4 level indenting the foraminal and extraforaminal portion of the exiting left L3 nerve root.

4. A right far lateral (extraforaminal) disc herniation indenting the extraforaminal portion of the exiting right L3 nerve root at L3-L4 level.

5. A lesion within the posterior epidural space at the L4 and L5 vertebral levels
which may represent an epidural lipoma/epidural lipomatosis.



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