Diagnosis: Other intervertebral disc degeneration, lumbosacral region Other spondylosis with myelopathy, lumbar regionClinical question: Evaluate pathology of new left LE weaknessSigns and Symptoms: New LLE weaknessComments: H/o spinal stenosis Cervical laminectomy 2006 | Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. There is multilevel disc desiccation present in the lower lumbar spineAt L5-S1 there is a left lateral recess disc extrusion present which impresses upon the nerve roots at the left lateral recess and displaces them and further extends into the left neural foramen where it encroaches on the left-sided exiting nerve roots. There are endplate reactive changes present at this level which are heterogeneous signal on T1 and T2. The disc extrusion was also present on the prior exams dating back to 2006. The endplate reactive change has progressed since 2006. Loss of disc space height at this level has progressed compared to 2006 is not significantly different than 2015.At L4-5 there is loss of disc space height associated with diffuse disc bulge and are shown effacement of the fat at the lateral recess bilaterally but worse on the right lateral recess versus the left lateral recess. Some disc material extends into the right neural foramen where it encroaches on the right-sided exiting nerve roots. There are endplate reactive changes present this level with large Schmorl's nodes. The disc bulge was also present on the prior exams dating back to 2006. The endplate reactive change has progressed since 2006. Loss of disc space height at this level has progressed compared to 2006 is not significantly different than 2015.At L3-4 there is redemonstration of a diffuse disc bulge which was also present on exams dating back to 2006. There is narrowing of the neural foramina present bilaterally with partial effacement of the fat surrounding the exiting nerve roots within the neural foramina. Endplate reactive changes are present at this level with Schmorl's nodes which has progressed since the 2006 exam.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There are degenerative changes present in the lower lumbar spine which have been present dating back to 2006. There is associated encroachment of the left-sided exiting nerve roots at L5-S1 and right-sided exiting nerve roots at L4-5 with a mild degree of spinal stenosis at L4-5 which was also present in 2006. Endplate reactive changes and loss of disk space height have progressed since 2006.