Assess for worsening spinal pathology s/p fall: bilateral radiculopathy, lumbago. There is a persistent eccentric disc extrusion at L5-S1 with marked loss of disc space height and degenerative bone marrow signal alterations and irregular contours of the adjacent endplates. There is associated severe left lateral recess and otherwise moderate central spinal canal narrowing at this level, with compression of left-sided nerve roots. There is also a left lateral disc protrusion at L4-5, which impinges upon the left-sided exiting nerve roots and moderate left neural foraminal narrowing. There is no significant spinal canal or neural foraminal narrowing at T12 through L4. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unchanged, with diffuse T1 and T2 hypointensity. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable, aside from dependent edema in the posterior subcutaneous tissues.
1. Persistent eccentric disc extrusion at L5-S1 associated severe left lateral recess and otherwise moderate central spinal canal narrowing at this level, with compression of left-sided nerve roots. 2. Persistent left lateral disc protrusion at L4-5, which impinges upon the left-sided exiting nerve roots. 3. The vertebral bone marrow signal is unchanged, with nonspecific diffuse T1 and T2 hypointensity.