Clinical question: Evaluate for spinal stenosis or neural foraminal compromise. Signs and symptoms: Lower back pain worse on the right and radicular pain down right leg. Nonenhanced lumbar MRI:Examination demonstrates normal anatomical alignment of the vertebral column without change since prior exam.There is a new however chronic mild compression deformity of the superior endplate of L1 and L2 since prior exam.Lower most visualized thoracic spine demonstrate mild degenerative changes at T9-T10 and T10-T11 levels. There is mild right neural foraminal compromise at T10-T11 and left neural foraminal compromise at T9-T10 level.T11-T12 is unremarkable.T12-L1 demonstrate minimal degenerative changes and unremarkable otherwise.L1-L2 demonstrate mild degenerative changes with resultant mild left neural foraminal compromise.L2-L3 demonstrate mild disc disease and moderate left facet and bilateral ligamentum flavum hypertrophy. There is mild central spinal stenosis, significant left neural foraminal and mild right neural foraminal compromise. There is interval progression of disease at this level since prior study.L3-L4 demonstrate mild disc disease and loss of disc height, significant left facet and moderate right facet hypertrophy changes and moderate symmetrical bilateral ligamentum flavum hypertrophy. Constellation of changes results in moderate central spinal stenosis, significant left and mild right neural foraminal compromise. There is mild interval progression of disease at this level since prior study.L4-L5 demonstrate mild disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy, moderate left facet hypertrophy and mild on the right. There is no central spinal stenosis or neural foraminal compromise. There is slight progression of disease at this level and including increased T2 signal intensity of the articulating facet on the left and a small synovial cyst projecting lateral to the left facet complex.L5-S1 demonstrate mild to moderate disc disease and loss of disc height, mild bilateral ligamentum flavum and articulating facet hypertrophic changes. No central spinal stenosis however moderate left and mild to moderate right neural foraminal compromise is present. Mild progression of disease at this level since prior exam.
1.There is interval progression of degenerative disc disease and hypertrophic changes of posterior elements since prior exam.2.There are new however chronic mild compression deformities of the superior endplates of L1 and L2 since prior study.3.Degenerative changes at L3-L4 results in moderate central spinal stenosis with mild interval progression since prior exam. Significant left and mild right neural foraminal compromise is also present.4.At L2-L3 there is mild progression of degenerative disease with mild central spinal stenosis, significant left and mild right neural foraminal compromise.5.No spinal stenosis at other levels.6.Please review detailed report above regarding neural foraminal compromise in the lower most visualized thoracic spine and lumbar spine.