Clinical question: Right lumbosacral pain for more than 3 months. Signs and symptoms: Right lumbosacral pain for more than 3 months, numbness to the knee, no weakness. Nonenhanced lumbar MRI:The signal intensity and alignment of vertebral column is unremarkable.In the lower most visualized thoracic spine and thoracic cord is unremarkable.T12-L1, L1-L2, L2-L3 and L3-L4 levels demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L4-L5 demonstrate mild disc disease, shallow broad-based bulging disc, mild bilateral ligamentum flavum and facet hypertrophic changes. There is mild mass effect on the thecal sac secondary to above changes however without convincing evidence of a spinal stenosis and no neural foraminal compromise.L5-S1 demonstrate moderate disc disease and loss of disc height moderate right and mild left facet and ligamentum flavum hypertrophy. No central spinal stenosis however mild right neural foraminal compromise is noted.No detectable. Spinal soft tissue abnormalities.
1.Degenerative changes of the lumbar spine as detailed per level above.2.There is no convincing evidence of central spinal stenosis at any level.3.L5-S1 demonstrate moderate disc disease and hypertrophic changes of posterior elements with resultant mild right neural foraminal compromise.