Clinical question: Low back pain. Signs and symptoms: No back pain. Nonenhanced lumbar MRI:Lower most visualized thoracic spine and thoracic cord from T10 inferiorly are unremarkable.Examination demonstrates extensive degenerative disc disease throughout the lumbar spine.T12-L1 demonstrate moderate disc disease and loss of disc height and mild hypertrophic changes of posterior elements without spinal stenosis or neural foraminal compromise.L1-L2 advanced disc disease and loss of disc height, mild bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis or significant neural foraminal compromise.L2-L3 demonstrates advanced disc disease and loss of disc height, moderate left and mild right facet and ligamentum flavum hypertrophy changes is present. Constellation of findings results in mild central spinal stenosis with moderate bilateral (L>R) neural foraminal compromise.L3-L4 demonstrate advanced disc disease and loss of disc height, significant asymmetric left-sided facet hypertrophy changes and mild right facet and ligamentum flavum hypertrophy. Constellation of changes results in mild to moderate central spinal stenosis with significant left and moderate right neural foraminal compromise.L4-L5 demonstrate moderate disc disease and loss of disc height, significant asymmetric right-sided ligamentum flavum and facet hypertrophy and to a lesser degree on the left. Constellation of changes results in significant bilateral neural foraminal and right lateral recess compromise with mild central spinal stenosis.L5-S1 demonstrate evidence of bilateral pars defect, mild grade 1 anterolisthesis, significant bilateral neural foraminal compromise and no central spinal stenosis.No detectable paraspinal soft tissue abnormalities.
1.L5-S1 demonstrate extensive degenerative changes, bilateral pars defect, mild grade 1 anterolisthesis, significant bilateral neural foraminal compromise without spinal stenosis.2.Extensive degenerative changes at L2-L3, L3-L4 and L4-L5 levels with resultant multilevel mild central spinal stenosis as detailed.3.Degenerative changes also results in bilateral neural foraminal compromise as detailed per level above.