Diagnosis: Thoracic or lumbosacral neuritis or radiculitis, unspecifiedClinical question: lower back pain with RLE radiculopathy 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.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a moderate degree of bilateral facet hypertrophy at this level-right worse than left.At L4-5 there is loss of disc space height, disc desiccation and diffuse disc bulge present at this level. There is bilateral facet and ligamentum flavum hypertrophy - right worse than left. There is effacement of the fat at the lateral recess is bilaterally right worse than left which is a result of both disc bulge and facet hypertrophy. There is moderate encroachment of the nerve root at the right lateral recess and mild encroachment of the nerve root at the left lateral recess at this level. The exiting nerve roots within the neural foramina are surrounded by fat at this level. There is a Schmorl's node present which is eccentric towards the right side. There are some endplate reactive changes at this level with the minimal signal hyperintensity on the T2 STIR images. There is a right far lateral disc protrusion at this level which mildly abuts the right-sided exiting nerve root as it exits the neural foramen. Overall there is mild to moderate spinal stenosis at this level. Comparison with the prior CT of the abdomen from 1/4/2013 does not indicate any obvious change, although subtle change may be overlooked due to differences in modality.At L3-4 there is loss of disc space height, disc desiccation and diffuse disc bulge present at this level. There is partial effacement of the fat at the lateral recesses bilaterally at this level and some mild strangulation of the thecal sac. There is ligamentum flavum hypertrophy present. The exiting nerve roots within the neural foramina are surrounded by fat at this level. There is a left far lateral disc protrusion at this level which abuts the left-sided exiting nerve root after it exits the neural foramen at this level. Overall there is mild spinal stenosis at this level. Comparison with the prior CT of the abdomen from 1/4/2013 does not indicate any obvious change, although subtle change may be overlooked due to differences in modality.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 is moderate encroachment of the nerve root at the right lateral recess and mild encroachment of the nerve root at the left lateral recess at L4-5 related to facet hypertrophy and disk bulge. Please correlate with patient's clinical symptoms and dermatome distribution of pain as this would affect potentially the L5 nerve roots.2.There is mild encroachment of the nerve roots at the lateral recesses at L3-4 related to combination of disc bulge and ligamentum flavum hypertrophy.3.There are far lateral disc protrusions on the right side at L4-5 and on the left side at L3-4 which abut the exiting nerve roots after they exit the neural foramina. This appears slightly worse at the L3-4 level.