Clinical question: Lumbar spinal stenosis. Signs and symptoms: Back pain with radiculopathy. Nonenhanced lumbar MRI:Unremarkable lower most visualized thoracic spine and thoracic cord.The alignment of vertebral column is anatomical. The signal intensity of vertebral column is unremarkable.T12 -- L1 demonstrate minimal degenerative changes and unremarkable otherwise.L1 -- L2 demonstrate mild degenerative changes and unremarkable otherwise.L2 -- L3 demonstrate mild disk disease, moderate asymmetric left facet hypertrophy and mild bilateral ligamentum flavum hypertrophy. No spinal stenosis. Mild right neural foraminal compromise.L3 -- L4 demonstrate moderate disk disease and loss of disk height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. Constellation of changes result in mild central spinal stenosis and moderate (right greater than left) bilateral neural foraminal compromise. There is no significant change of the findings at this level since prior exam.L4 -- L5 demonstrate moderate disk disease and loss of disk height, moderate bilateral (left greater than right) facet and ligamentum flavum hypertrophic changes. There is interval decreased T2 hyperintensity of the facets at space on the left since prior exam suggestive of synovitis. There is revisualization of a small central disk protrusion at this level which in combination with broad base bulging disk results in moderate central spinal stenosis without convincing evidence of interval change. Moderate bilateral neural foraminal compromise is noted.L5 -- S1 re-demonstrate mild disk disease and loss of disk height, small central and left paramedian annular fissure, mild bilateral facet and ligamentum flavum hypertrophic changes. No spinal stenosis or neural foraminal compromise.
1.Degenerative changes at L4 -- L5 results in moderate central spinal stenosis and bilateral neural foraminal compromise. No significant change since prior exam. There is however interval resolution of previously noted facet space widening and fluid signal intensity.2.Degenerative changes at L3 -- 4 with resultant mild central spinal stenosis and bilateral neuroforaminal compromise without significant change.3.Incidental note is made of a partially visualized right renal cyst.