Clinical question: Low back pain and leg pain. Signs and symptoms: Low back pain and leg pain. Nonenhanced lumbar MRI:The alignment of vertebral column is anatomical.The signal intensity of vertebral column demonstrate changes related to degenerative disease and unremarkable otherwise.T11-T12 demonstrate mild degenerative changes and unremarkable otherwise.T12-L1 demonstrate mild hypertrophic changes of posterior elements and unremarkable otherwise.L1-L2 demonstrate mild disc disease and mild asymmetric left-sided facet and ligamentum flavum hypertrophy. There is also asymmetric left-sided lateral and far lateral disc bulge. Constellation of above findings results in moderate to significant left neural foraminal compromise and mild central spinal stenosis. Tiny synovial cysts are noted projecting posterior and inferior to the left articulating facet.L2-L3 demonstrate moderate disc disease, loss of disc height and asymmetric mild to moderate left facet and ligamentum flavum hypertrophy. Constellation of findings results in mild spinal stenosis, moderate bilateral neural foraminal compromise.L3-L4 demonstrate advanced disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. There is a shallow broad-based right lateral and far lateral disc protrusion. Constellation of changes results in moderate central spinal stenosis and significant right and mild to moderate neural foraminal compromise.L4-L5 demonstrate advanced disc disease and loss of disc height and asymmetric moderate to significant right facet and ligamentum flavum hypertrophy and to a lesser degree on the left. Shallow broad-based bulging disc is also noted. There is resultant significant right and moderate left neural foraminal compromise and no central spinal stenosis.L5-S1 demonstrate mild disc disease and loss of height, moderate asymmetric right facet and ligamentum flavum hypertrophy and to a lesser degree on the left. There is no central spinal stenosis however moderate right neural foraminal compromise is present.Visualized SI joints are unremarkable.Paraspinal soft tissues are unremarkable.
1.Degenerative changes of lumbar spine with resultant moderate central spinal stenosis at L3-L4 and mild spinal stenosis at L1-L2 and L2-L3 levels.2.There are shallow broad-based disc protrusion and multilevel neural foraminal compromise (some significantly) as detailed per level above.