Diagnosis: Lumbago with sciatica, unspecified sideClinical question: lbp, radiculopathySigns and Symptoms: as above 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.At L4-5 there is loss of disc space height, disc desiccation and a diffuse disc bulge associated with partial effacement of the fat at the right lateral recess and partial effacement of the fat surrounding the exiting nerve roots within the neural foramina.At L3-4 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with moderate facet hypertrophy. There is effacement of the fat at the lateral recess bilaterally at this level and some partial effacement of spinal fluid surrounding the nerve roots at this level. There is narrowing of the neural foramina bilaterally at this level and effacement of fat surrounding the exiting nerve roots. Overall there is moderate spinal stenosis and encroachment of exiting nerve roots bilaterally at this level. There is mild anterior subluxation of L3 on L4 at this level.At L2-3 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with effacement of the fat at the left lateral recess and partial effacement of the fat at the right lateral recess. There is bilateral ligamentum flavum hypertrophy at this level. There is narrowing of the neural foramina with encroachment of the exiting nerve roots within the left neural foramen due to combination of disc bulge and ligamentum flavum hypertrophy. There are endplate reactive changes present at this level which are bright on T2 and low signal on T1 indicating that these are in the subacute stage. There is mild anterior subluxation of L2 on L3 at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is loss of disc space height and disc desiccation associated with a disc bulge at T11-T12.
1.There is moderate spinal stenosis present at L3-4 associated with encroachment of the exiting nerve roots due to degenerative changes and mild anterior subluxation.2.Degenerative changes and a minor anterior subluxation at L2-3 are associated with acute or subacute endplate reactive changes and some mild encroachment of the nerve roots of the left lateral recess and left neural foramen at this level3.There is some mild encroachment of the nerve roots at the right lateral recess at L4-5 due to a disc bulge with some mild encroachment of the exiting nerve roots at L4-5.4.There are multilevel degenerative changes present in the lumbar spine.