Clinical question: Evaluate for spinal stenosis, history of T12 compression fracture signs and symptoms: Neurogenic claudication Nonenhanced lumbar MRI:T10-T11 is unremarkable.T11-T12 demonstrate mild compression deformity of the superior endplate of T12 which is new since prior lumbar MRI exam from 2012. This finding is associated with subtle T2/T2 stir hyperintensity of the adjacent bone marrow suggestive of edema and suggesting of acute process. There is no evidence of expansion of mildly compressed vertebra into the spinal canal. Hypertrophic changes of the ligamentum flavum posteriorly as well as degenerative changes of the disc at this level results in mild central spinal stenosis with significant left and moderate right neural foraminal compromise. There are no axial images acquired through this level and findings are assess based on sagittal images only.T12-L1 demonstrate moderate disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. There is no central spinal stenosis however moderate left and mild right neural foraminal compromise is detected.L1-L2 demonstrate mild disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease without central spinal stenosis. There is no significant neural foraminal compromise. Degenerative changes at this level demonstrate interval progression since prior exam.L2-L3 demonstrate mild disc disease and loss of disc height, moderate to significant bilateral ligamentum flavum hypertrophy and mild bilateral facet disease without significant hypertrophic changes. Constellation of findings results in moderate central spinal stenosis, moderate left and mild right neural foraminal compromise. Degenerative changes at this level and including central spinal stenosis demonstrate mild interval progression.L3-L4 demonstrate mild disc desiccation, severe bilateral ligamentum flavum hypertrophy and mild (L>R) facet degenerative disease without significant hypertrophy. Constellation of findings results in moderate central spinal stenosis, moderate to severe right and mild to moderate left neural foraminal compromise. Degenerative changes at this level demonstrate subtle interval progression.L4-L5 demonstrate mild disc disease without significant loss of disc height, significant bilateral ligamentum flavum hypertrophy and mild left and moderate right facet degenerative changes and hypertrophy. Constellation of changes results in significant central spinal stenosis with interval progression since prior exam from 2012. Mild to moderate bilateral neural foraminal compromise demonstrate no significant change.L5-S1 demonstrates moderate disc disease, loss of disc height, significant bilateral ligamentum flavum and facet hypertrophic changes and evidence of mild grade 1 anterolisthesis. There is interval progression of degenerative changes at this level however without convincing evidence of central spinal stenosis. Moderate bilateral foraminal compromise with mild interval progression.
1.New since prior lumbar MRI there is mild compression deformity of superior endplate of T12 without retropulsion into the spinal canal. Degenerative changes at T11-T12 however results in mild central spinal stenosis as detailed above.2.Interval mild progression of degenerative changes of lumbar spine and including multilevel central spinal stenosis at L2-L3, L3-L4 and more significantly at the L4-L5 levels as detailed.3.Multilevel neural foraminal compromise as detailed per level above.