Clinical question: Evaluate for progression of lumbar disease. Signs and symptoms: Back pain. Nonenhanced lumbar MRI:The signal intensity of the vertebral column demonstrate changes secondary to degenerative disease and are unremarkable otherwise.The alignment of vertebral column remains anatomical however there is mild straightening lumbar lordosis.Normal visualized thoracic spine and thoracic cord from T10 inferiorly is unremarkable.T12 -- L1 is unremarkable.L1 -- L2 is unremarkable.L2 -- L3 demonstrate mild disk disease and subtle loss of disk height and moderate bilateral (left greater than right) facet hypertrophic changes and including the left facet effusion. Mild to moderate bilateral (right greater than left) ligamentum flavum hypertrophy is also noted. There is resultant mild central spinal stenosis and no neural foraminal compromise. There is a slight progression of degenerative changes since prior exam.L3 -- L4 demonstrate mild disk disease and loss of disk height, moderate bilateral ligamentum flavum hypertrophy and mild bilateral facet hypertrophic changes. There is no spinal stenosis and no neural foraminal compromise. There is no significant change in extent of changes since prior study.L4 -- L5 demonstrate mild disk disease, moderate to severe (left greater than right) ligamentum flavum hypertrophic changes and mild bilateral facet hypertrophic changes. Constellation of changes results in moderate central spinal stenosis. There is no appreciable change in the extent of degenerative changes since prior study.L5 -- S1 demonstrate moderate disk disease and loss of disk height, mild to moderate symmetrical bilateral ligamentum flavum hypertrophy and mild bilateral facet disease and facet effusion. There is no central spinal stenosis or neural foraminal compromise. There is however mild compromise of the lateral recess of the canal bilaterally. Although there is no significant change in the extensive of degenerative changes at this level there is interval decreased size of broad-based disk protrusion far laterally on the left since prior exam.
1.Degenerative changes of disks and the posterior elements demonstrate mild progression since prior exam as detailed.2.At L2 -- L3 mild central spinal stenosis again noted without significant change.3.Moderate central spinal stenosis at L4 -- L5 without significant change.4.At L5 -- S1 there is interval decreased size of far left lateral disk protrusion since prior exam.5.No significant neural foraminal compromise at any level.