Clinical question: Spinal stenosis. Signs and symptoms: Spinal stenosis. Nonenhanced lumbar MRI:The signal intensity in the anatomical alignment of the vertebral column is unremarkable.T11-T12 demonstrate mild degenerative changes and unremarkable otherwise.T12-L1 demonstrate mild degenerative disease and unremarkable otherwise.L1-L2 demonstrate mild degenerative disease and unremarkable otherwise.L2-L3 demonstrate mild disc disease and mild asymmetric left-sided facet and mild bilateral mental problem hypertrophic changes without spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild disc disease, mild bilateral ligamentum flavum hypertrophy and mild asymmetric left-sided facet hypertrophic changes. No spinal stenosis. There is moderate left neural foraminal compromise secondary to asymmetric left facet hypertrophy changes. Patent right neural foramen.L4-L5 demonstrate moderate disc disease and loss of disc height, shallow broad-based bulging disc, mild left ligamentum flavum hypertrophy and the moderate left and mild right facet hypertrophic changes. There is evidence of laminectomy at this level with resultant expansion of thecal sac and no central spinal stenosis. There is however significant bilateral neural foraminal compromise primarily secondary to hypertrophic changes of posterior elements.5-S1 demonstrate postoperative changes of bilateral laminectomy and without evidence of central spinal stenosis. There is advanced disc disease with near complete loss of disc height and mild degenerative changes of posterior elements. No evidence of neural foraminal.The paraspinal soft tissues are unremarkable.
1.There is no evidence of central spinal stenosis at any level as is questioned clinically.2.Postoperative laminectomy changes at L4-L5 and L5-S1 levels.3.Significant bilateral neural foraminal compromise at L4-L5.