Diagnosis: Other intervertebral disc displacement, lumbar region Sacrococcygeal disorders, not elsewhere classified Low back painClinical question: eval for disc herniationSigns and Symptoms: lbp for 2 years 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 small central disc protrusion present at this level. This is stable compared to the prior exam.At L4-5 there is a right lateral recess disc extrusion present which encroaches on the nerve roots of the right lateral recess and extends behind the L5 vertebral body at the right lateral recess. There is also loss of disc space height and endplate reactive change present at this level. The endplate reactive changes T1 hyperintense. When compared to the exam from 6/5/2014 the disc extrusion has changed. It now tracks behind the L5 vertebral body whereas it previously was centered at the disc space level.At L3-4 there is no significant compromise to spinal canal or neural foramina.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.
Since the prior exam, a disc extrusion at L4-5 which compresses the nerve roots of the right lateral recess has migrated further behind the L5 vertebral body that on the prior exam.