LumbagoClinical question: Reason for low back painSigns and Symptoms: low back pain left thigh pain reduced left patellar reflex 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. There is loss of disc space height, disc desiccation, chronic endplate reactive changes in the disc bulge present at this level. Some mild ligamentum flavum hypertrophy present at this level. There is partial effacement of the fat at the left lower recess at this level. There is effacement of the fat surrounding the left-sided exiting nerve root at this level and some mild narrowing of the right neural foramen. When compared to the prior exam these findings have progressed.At L4-5 there is no significant compromise to spinal canal. There is loss of disc space height, disc desiccation and chronic endplate reactive change at this level associated with a diffuse disc bulge and mild-to-moderate facet and ligamentum flavum hypertrophy left worse than right where with subchondral cyst formation. There is some narrowing of the spinal canal at this level with some mild partial effacement of the fat at the lateral recesses sees. There is effacement of the fat surrounding the left-sided exiting nerve root within the neural foramen and some mild narrowing of the right neural foramen.At L3-4 there is no significant compromise to spinal canal. There is loss of disc space height, disc desiccation and diffuse disc bulge associated with chronic endplate reactive changes. There is some mild triangulation of the thecal sac and some ligamentum flavum hypertrophy bilaterally. There is narrowing of the right neural foramen at this level associated with effacement of fat surrounding the right-sided exiting nerve rootAt L2-3 there is no significant compromise to spinal canal. There is a diffuse disc bulge present at this level associated with mild ligamentum flavum hypertrophy.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is a right renal cyst present which currently measures 13 mm and previously measured 5 mm in diameter. Breathing artifact partially obscures visualization of the kidneys on this exam.
1.There are degenerative changes present in the lower lumbar spine with encroachment of the left-sided exiting nerve roots within the neural foramina of L5-S1 and L4-5 and right-sided exiting nerve root within the neural foramen of L3-4. When compared to the prior exam from 2010 the encroachment at L5-S1 has progressed.2.A right-sided cortically based renal cyst has enlarged when compared to the prior exam.