Diagnosis: Backache, unspecifiedClinical question: r/o Herniated diskSigns and Symptoms: back pain, numbness of legs and sciatica Five lumbar type nonrib-bearing vertebral bodies are presumed to be present which are appropriate in overall height. We consider L1-L2 to be at the level of the left renal vein. Based on this information, there is some sacralization of L5.The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is loss of disc space height, disc desiccation, diffuse disc bulge and bilateral facet hypertrophy of a moderate degree associated with anterior subluxation of L4 and L5. There is effacement of the fat at the lateral recess bilaterally and significant narrowing the spinal canal. Overall there is a a moderate to severe degree of spinal stenosis at this level. The exiting nerve roots within the neural foramina are surrounded by fat at this level. At L3-4 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with moderate facet and ligamentum flavum hypertrophy. There is effacement of the fat at the left lateral recess at this level. The exiting nerve roots within the neural foramina are surrounded by fat at this level. Overall there is a mild to moderate degree of spinal stenosis present at this level..At L2-3 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with mild to moderate bilateral facet and ligamentum flavum hypertrophy. There is partial effacement of the fat at the lateral recess bilaterally at this level with a mild to moderate degree of spinal stenosisAt L1-2 there is no significant compromise to spinal canal or neural foramina. There is a diffuse disc bulge present this level associated disc desiccation. There is facet hypertrophy and right side at this level.
1.Please note the variant enumeration of the lumbar vertebrae. There is sacralization of L5 present.2.There is moderate to severe spinal stenosis present at L4-5 due to disc disease, facet disease and mild subluxation.3.There is mild to moderate spinal stenosis at L3-4 associated with encroachment of the nerve roots at the left lateral recess.4.There is mild to moderate spinal stenosis present at L2-3 due to degenerative changes.5.There are multilevel degenerative changes