65 years Male (DOB:12/15/1950)Reason: lumbar radiculopathy History: lumbar radiculopathyPROVIDER/ATTENDING NAME: RICHARD W KANG RICHARD W KANG 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.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height and some endplate reactive changes as well as disc desiccation at this level associated with a diffuse disc bulge and mild facet hypertrophy. Although the neural foraminal are narrowed, within the neural foramina the exiting nerve roots are surrounded by fat.At L4-5 there is a diffuse disc bulge and a superimposed left paramedian disc extrusion which disc extrusion impresses on the thecal sac and effaces the spinal fluid within the thecal sac at this level. Some disc material extends behind the adjacent endplates. Overall there is moderate to marked spinal stenosis at this level. There is effacement of the fat at the left lateral recess at this level. There are some mild facet and ligamentum flavum hypertrophy at this level. Although the neural foraminal are narrowed, within the neural foramina the exiting nerve roots are surrounded by fat.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and a diffuse disc bulge at this level. There are endplate reactive changes at this level which are high signal on T1 and T2 and suppresses on the inversion recovery images. These are chronic endplate reactive changes.At L2-3 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height and a disc bulge as well as some endplate reactive changes which are high signal on T1 and suppresses on the STIR images indicating they are chronic.At L1-2 there is no significant compromise to spinal canal or neural foramina. There are Schmorl's nodes present at this level.
1.There are multilevel degenerative changes present in the lumbar spine which are worse at L4-5 where there is moderate to severe spinal stenosis as a result of a left paramedian disc extrusion .