Clinical question: known DJD, worsened pain. Signs and Symptoms: as above Nonenhanced lumbar MRI:Lower most visualized thoracic spine demonstrate advanced disc disease at T11-T12 level with mild bulging disc resulting in subtle flattening deformity of the ventral aspect of the cord however without spinal stenosis. This finding demonstrate mild interval progression since prior study.T12-L1 demonstrate mild disc disease and loss of disc height, mild bulge of the disc, mild bilateral facet and ligamentum flavum hypertrophy without spinal stenosis or neural foraminal compromise.L1 -2 demonstrate minimal disc desiccation and unremarkable otherwise.L2-L3 demonstrate mild disc desiccation, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild disc disease, mild to moderate ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis however mild to moderate left neural foraminal compromise is present.L4-L5 demonstrate mild disc disease with loss of disc height, diffuse broad-based bulging disc, moderate to significant bilateral ligamentum flavum hypertrophy and mild to moderate bilateral facet hypertrophy changes. There is also grade 1 anterolisthesis at this level. Constellation of changes results in significant central spinal stenosis and moderate left and mild right neural foraminal compromise. There is slight interval progression changes at this level since prior exam from 2003.L5-S1 demonstrate mild disc disease, moderate bilateral ligamentum flavum and mild bilateral facet hypertrophic changes are present. No spinal stenosis or neural foraminal compromise.No detectable paraspinal soft tissue abnormalities.
1.At L4-L5 extensive degenerative changes and including mild grade 1 anterolisthesis results in significant central spinal stenosis and moderate left neural foraminal compromise. Progression since 2003 exam is mild.2.There is evidence of mild interval progression of degenerative changes however without evidence of spinal stenosis or significant neural foraminal compromise at any other level. Please review detailed report per level above.