Clinical question: Evaluate for compression fracture, DDD, lower back pain with left leg weakness. Signs and symptoms: Lower back pain radiating to left buttock and down leg. Nonenhanced lumbar MRI:T11-T12 is unremarkable.T12-L1 demonstrate chronic approximately 50% compression fracture of L1 vertebral body with resultant mild bulge of the superior aspect of compressed vertebrae into the spinal canal without definitive central spinal stenosis. Signal intensity of the adjacent cord and conus is within normal. There is also no detectable neural foraminal compromise.L1-L2 demonstrate mild disc disease, loss of disc height, mild bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis and mild right neural foraminal compromise is present.L2-L3 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild to moderate disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy and mild bilateral facet disease. Degenerative changes also results in mild grade 1 anterolisthesis at this level and with resultant moderate central spinal stenosis with significant (right greater than left) neural foraminal compromise.L4-L5 demonstrate mild disc disease and loss of disc height, mild to moderate bilateral ligamentum flavum hypertrophy and mild facet disease. There is a central small disc protrusion projecting into the ventral epidural space and without mass effect on the thecal sac. No evidence of spinal stenosis and patent bilateral neural foramina.L5-S1 demonstrate mild degenerative disc disease and facet/ligamentum flavum hypertrophy without spinal stenosis or neural foraminal compromise. Diffuse T1 and T2 hyperintense and T2 STIR isointense signal intensity of the L5 vertebral body consistent with fatty deposit.Unremarkable paraspinal soft tissues.
1.Chronic approximately 50% compression fracture of superior endplate of L1 vertebrae with mild bulge into the spinal canal without spinal stenosis or clinically significant neural foraminal compromise.2.Moderate degenerative changes at L3-L4 and including mild grade 1 anterolisthesis with resultant moderate central spinal stenosis.3.Tiny central disc protrusion at L4-L5 without mass effect on the thecal sac, central spinal stenosis as detailed.4.Multilevel mild neural foraminal compromise as detailed per level above.