Clinical question: Lumbar radiculopathy. Signs and symptoms: Right sciatica. Nonenhanced lumbar MRI:Examination demonstrates mild dextroscoliosis centered at L3-L4 level and weight grade 1 right lateral listhesis at L3-4 level.On sagittal images there is also evidence of grade 1 anterolisthesis at L3-L4 level.T11-T12 is unremarkable.T12-L1 is unremarkable.L1-L2 demonstrate mild disc disease and facet/ligamentum flavum hypertrophy and result in mild central spinal stenosis without neural foraminal compromise.L2-L3 demonstrate moderate disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy without significant facet hypertrophy. There is however bilateral facet space widening and effusion. Constellation of changes results seen moderate central spinal stenosis with mild right and moderate to significant left neural foraminal compromise.L3-L4 demonstrate advanced degenerative disc with significant loss of disc height, moderate bilateral ligamentum flavum hypertrophy, mild bilateral facet disease. There is evidence of grade 1 anterolisthesis as well as right lateral listhesis at this level. Constellation of changes results in significant central spinal and bilateral (L>R) stenosis.L4-L5 demonstrate mild disc disease, moderate bilateral ligamentum flavum hypertrophy without significant facet hypertrophic changes. There is however mild bilateral facet effusion present. There is increased dorsal epidural fat at this level and constellation of changes results in mild central spinal stenosis at this level with mild to moderate left and significant right neural foraminal compromise.L5-S1 demonstrate mild disc disease and mild bilateral facet and ligamentum flap and degenerative changes without spinal stenosis or neural foraminal compromise.
1.Advanced degenerative changes at L3-L4 and including grade 1 anterolisthesis as well as right lateral listhesis results in significant central spinal stenosis and significant bilateral neural foraminal compromise.2.Degenerative changes at L2-L3 results in moderate central spinal stenosis and bilateral neural foraminal compromise as detailed above.3.Degenerative changes at L4-L5 level results in mild central spinal stenosis with significant right and mild to moderate left neural foraminal compromise.4.Please review detailed report per level above for additional findings.