Reason: radiculopathy on EMG History: pain Mild straightening of the lumbar spine, otherwise alignment is anatomic. Vertebral body heights are maintained. Multilevel disc desiccation with moderate disc space loss at L4-L5. No abnormal signal within the cord or conus which ends at L1-L2. Endplate degenerative marrow signal changes at L4-L5.T12-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: Mild diffuse disc bulge. Moderate facet arthropathy and ligamentum flavum thickening. Moderate spinal canal stenosis. Mild bilateral neural foraminal stenosis.L4-L5: Diffuse disc bulge with moderate facet arthropathy and ligamentum flavum thickening. There is severe spinal canal stenosis at this level. There is low T2 signal filling the spinal canal at this level which may represent extruded disc material, Mild to moderate bilateral neural foraminal stenosisL5-S1: Diffuse disc bulge. Mild effacement of the right lateral recess without central canal stenosis. No significant neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
Multilevel degenerative changes as detailed above with severe spinal canal stenosis at L4-L5 and moderate L3-L4 spinal canal stenosis. Mild L3-L4 and L4-L5 neural foraminal stenosis.There is low T2 signal filling the spinal canal at the L4-L5 level which is suspected to represent extruded disc material; component of flow-related artifact however is not entirely excluded. Additional imaging with a 3D T2 FIESTA sequence would be helpful. 