Clinical question: persistent sciaticaSigns and Symptoms: back and leg pain 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 loss of disc space height, disc desiccation and diffuse disc bulge present at this level. There is mild facet and ligamentum flavum hypertrophy at this level. There is partial effacement of the fat surrounding the exiting nerve roots within the neural foramina at this level.At L4-5 there is a moderate degree of bilateral facet and ligamentum flavum hypertrophy associated with a disc bulge and disc desiccation. There is a couple millimeters anterior subluxation of L4 on L5 present. There is partial effacement of the fat surrounding the exiting nerve roots within the neural foramina at this level. There is mild triangulation of the thecal sac at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is a mild disc bulge present at this level.At L2-3 there is a right paramedian disc extrusion present with disc material tracking behind the L3 vertebral body. This extrusion is associated with encroachment at the right lateral recess at the L3 vertebral body level. Disc material extends towards the right neural foramen at L3-4.At L1-2 there is no significant compromise to spinal canal or neural foramina.There are renal cysts present.
1.There is a disc extrusion present at L2-3 with disc material extending behind the L3 vertebral body and towards the right L3-4 neural foramen which encroaches on the nerve roots at the right lateral recess at L2-3 as the course into the right L3-4 neural foramen.2.There are multilevel degenerative changes present in the lumbar spine which are worse at L4-5 where there is a mild degree of spinal stenosis and some mild subluxation and mild encroachment of exiting nerve roots within the neural foramina.