69 years Male (DOB:4/22/1947)Reason: Left lumbar radiculopathy History: pain left buttockPROVIDER/ATTENDING NAME: RODERICK H BIRNIE RODERICK H BIRNIE 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. There is straightening of the normal lumbar curvature.At L5-S1 there is loss of disc space height, disc desiccation and endplate reactive change. The endplate reactive changes bright on T1 and suppresses on inversion recovery imaging. There is a broad-based right lateral recess disc protrusion present extending into the right neural foramen at this level. It is associated with effacement of fat at the right lateral recess and some encroachment of the nerve roots of the right lateral recess. There is ligamentum flavum and facet hypertrophy present at this level which is more on the right when compared to the left side.At L4-5 there is a diffuse disc bulge present at this level associated with bilateral facet and ligamentum flavum hypertrophy and effacement of the fat at the lateral recesses. There is crowding of the nerve roots at this level. Overall there is a moderate degree of spinal stenosis present at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is a diffuse disc bulge and bilateral facet and ligamentum flavum hypertrophy at this level. There is some narrowing of the spinal canal.At L2-3 there is no significant compromise to spinal canal or neural foramina. There is a mild disc bulge at this levelAt L1-2 there is no significant compromise to spinal canal or neural foramina. There is a disc bulge present this level associated with endplate reactive change. Endplate reactive changes dark on T1 and bright on T2 and inversion recovery.
1.There are multilevel degenerative changes present lumbar spine with moderate spinal stenosis at L4-5 and encroachment of nerve roots of the right lateral recess at L5-S1.2.There are endplate reactive changes present at L1-2 associated with some subacute inflammatory change. Most likely this is related to degenerative change. Please correlate with clinical history. Follow-up exam would help confirm this.