Diagnosis: Lumbago with sciatica, unspecified sideClinical question: lumbar spine pain. LLE radicular symptomsSigns and Symptoms: LLE radicular symptoms Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is bilateral facet hypertrophy present at this level.At L4-5 there anterior subluxation of L4 on L5, disc desiccation and diffuse disc bulge associated with marked bilateral facet and ligamentum flavum hypertrophy. There is partial effacement of spinal fluid within the thecal sac at this level with a moderate degree of spinal stenosis. There is partial effacement of fat surrounding the exiting nerve roots within the neural foramina at this level. Compared to the previous exam from 5/17/2008 there is been clear progression.At L3-4 there is no significant compromise to spinal canal or neural foramina. There are some ligamentum flavum hypertrophy present at this level.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.There is a 32mm right renal cyst which previously measured . The left kidney is not entirely included exam and appears to have associated enlargement of the renal cysts and appear smaller than the right kidney.There is some disc desiccation and minor disc bulges at T11-T12, T10 - T11 and T9-T10.
1.Degenerative changes are present which are worse at L4-5 where there is mild subluxation as well as marked facet hypertrophy, disc bulge and moderate spinal stenosis as well as mild encroachment of exiting nerve roots. Compared to the prior exam from 2008, there significant progression.2.Interval enlargement of renal cysts over the past 7 years. There appears to be some atrophy of the left kidney which to some degree is also present on the prior exam