Diagnosis: Other intervertebral disc displacement, lumbar regionClinical question: new pain to left legSigns and Symptoms: new pain to left. Has history of right sided leg pain 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 bilateral facet hypertrophy of a moderate to marked degree associated with disc desiccation. There is associated encroachment of the nerve roots within the neural foramina bilaterally at this level and some partial effacement of the fat at the lateral recess on the left side. These findings are stable when compared to the previous exam.At L4-5 there is redemonstration of loss of disc space height, disc desiccation and diffuse disc bulge associated with endplate reactive changes. The endplate reactive changes are bright on T1. There is associated moderate bilateral facet and ligamentum flavum hypertrophy as well as effacement of spinal fluid surrounding the nerve roots within the thecal sac. Overall there is a moderate to marked degree of spinal stenosis present at this level. There is also effacement of the fat surrounding the exiting nerve roots on the right side at this level. When compared to the prior exam these findings are stable.At L3-4 there is diffuse disc bulge associated with a moderate degree of bilateral facet and ligamentum flavum hypertrophy. There is disc desiccation present. There are some mild endplate reactive changes present which are bright on T1 imaging. The fat at the lateral recesses is effaced bilaterally at this level and there is some crowding of the nerve roots within the thecal sac. Overall there is moderate spinal stenosis at this level. There is narrowing of the neural foramina bilaterally at this level. The exiting nerve roots within the neural foramina are surrounded by fat. Overall these findings have not changed compared to the prior examAt L2-3 there is disc desiccation and a right far lateral disc protrusion which extends into the right neural foramen and mildly displaces the right-sided exiting nerve root after it exits the neural foramen.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is disc desiccation present at this level.
1.There is redemonstration and no change of multilevel degenerative changes present in the lumbar spine with a moderate to severe degree of spinal stenosis at L4-5 and moderate spinal stenosis at L3-4 as well as some encroachment of the exiting nerve roots within the neural foramina on the left side at L5-S1 and the right-side at L4-5.2.There is a right far lateral disc protrusion at L2-3 which mildly displaces the right sided exiting nerve roots after the exit the neural foramen at this level. This is also stable compared to the prior exam