Diagnosis: Spinal stenosis, cervical regionClinical question: degenerative or mass lesionsSigns and Symptoms: severe excruciating lower back pain and shooting leg pains resistant to medical treatment. Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.There is epidural lipomatosis present with some effacement of spinal fluid surrounding the nerve roots in the lower thecal sacAt L5-S1 there is no significant compromise to spinal canal. There is some loss of disc space height, diffuse disc bulge, disc desiccation and bilateral facet and ligamentum flavum hypertrophy (right more than left) with effacement of the fat surrounding the right-sided exiting nerve root within the neural foramen.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space heights disc desiccation and mild disc bulge and mild to moderate bilateral facet and ligamentum flavum hypertrophy level.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is mild facet hypertrophy at this level.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.The right kidney appears to be larger than the left kidney.
1.There are degenerative changes present in the lower lumbar spine with resultant encroachment of the right-sided exiting nerve roots within the right neural foramen at L5-S1 due to facet hypertrophy and disc bulge.2.There is epidural lipomatosis present in the lower lumbar spine which is associated with narrowing of the thecal sac and some effacement of spinal fluid surrounding the nerve roots in the lower lumbar thecal sac. Please correlate with patient's clinical symptoms.