Clinical question: Evaluate for foraminal stenosis and disk protrusion. Signs and symptoms: Right foot numbness and pain. Nonenhanced lumbar MRI:T12 -- L1 demonstrate mild changes unremarkable otherwise.L1 -- L2 demonstrate mild degenerative changes and unremarkable otherwise.L2 -- L3 demonstrate mild this disease and mild to moderate bilateral ligamentum flavum hypertrophy however without spinal stenosis or neural foraminal compromise.L3 -- L4 demonstrate mild disk disease and moderate bilateral ligamentum flavum hypertrophy. No spinal stenosis or neuroforaminal compromise.L4 -- L5 demonstrate advanced disk disease with significant loss of disk height, significant right and moderate left ligamentum flavum hypertrophy and mild facet disease. There is no convincing evidence of central spinal stenosis. Asymmetric right-sided ligamentum flavum hypertrophy protrudes into the right neural foraminal with resultant moderate foraminal compromise. Patent left neural foramina.L5 -- S1 demonstrate moderate disk disease and loss of disk height, moderate left facet and moderate bilateral ligamentum flavum hypertrophy. There is a broad-based central and rightward disk protrusion projecting into the epidural space and without significant mass effect on the thecal sac. It results in significant right lateral recess compromise. There is also moderate bilateral neural foraminal compromise secondary to hypertrophic changes of posterior elements.
1.Degenerative changes primarily centered at L4 -- 5 and L5 -- S1 levels however without evidence of central spinal stenosis. There are moderate bilateral neural foraminal compromise at L5/S1 level and a broad-based central and rightward disk protrusion with resultant significant right lateral recess compromise. Moderate right neuroforaminal compromise at L4 -- 5. 2.Mild degenerative changes at other levels as detailed per level above.