Clinical question: Low back pain. Signs and symptoms: Same. Nonenhanced lumbar MRI:The lowermost visualized thoracic spine demonstrate extensive disk disease and loss of disk height with resultant central spinal stenosis at T10 -- T11 level. Moderate bilateral neural foraminal compromise is also detected.T12 -- L1 demonstrate advanced disk disease and loss of disk height, mild grade 1 retrolisthesis, mild bilateral facet and ligamentum flavum hypertrophy. There is no central spinal stenosis however moderate right neural foraminal compromise is present.L1 -- L2 is unremarkable.L2 -- L3 demonstrate mild degenerative changes and without spinal stenosis or neural foraminal compromise.L3 -- L4 demonstrate mild disk desiccation and loss of height, moderate bilateral facet and ligamentum flavum hypertrophy. Constellation of changes results in mild central spinal stenosis and mild to moderate right neural foraminal compromise.L4 -- L5 demonstrate mild disk disease and loss of disk height, broad based bulging disk, significant bilateral facet and ligamentum flavum hypertrophic changes. There is resultant significant central spinal stenosis and with severe right and moderate left neural foraminal compromise.L5 -- S1 demonstrate mild degenerative disk disease and mild bilateral facet and ligamentum flavum hypertrophy. There is moderate right neural foraminal compromise and unremarkable otherwise.
1.Extensive degenerative changes at L4 -- L5 with resultant significant central spinal stenosis as detailed.2.Degenerative changes at T10 -- T11 resulting in central spinal stenosis and neural foraminal compromise.3.No evidence of central spinal stenosis at any other level.4.Multi-level neural foraminal compromise however is noted as detailed per level above.