Clinical question: Assess for lumbar spinal stenosis. Signs and symptoms: Lower extremity pain and weakness. Nonenhanced lumbar MRI:T11-T12, T12-L1 and L1-L2 levels are unremarkable.L2-L3 demonstrate a tiny right lateral small disc protrusion which projects into the inferior aspect of the right L2-L3 neural foraminal without detectable neural foraminal compromise or mass effect on the right L2 nerve root (sagittal T2 and T2 stair image 6 as well as axial T2 series 701 imaging 9). Unremarkable exam otherwise.L3-L4 demonstrate mild disc desiccation and mild bilateral ligamentum flavum hypertrophy with mild facet disease. No spinal stenosis or neural foraminal compromise.L4-L5 demonstrate moderate to advanced disc disease and loss of disc height, moderate bilateral facet and moderate to severe bilateral ligamentum flavum hypertrophy as well as mild grade 1 anterolisthesis. Constellation of findings results seen significant central spinal stenosis and significant bilateral (R>L) neural foraminal compromise. Facet disease at this level is associated with mild bilateral facet space T2 hyperintensity suggestive facet effusion.L5-S1 demonstrate moderate disc desiccation, mild bilateral facet and ligamentum flavum degenerative/hypertrophic changes however without the spinal stenosis or neural foraminal compromise.
1.L4-L5 demonstrate extensive degenerative/hypertrophic changes and including grade 1 anterolisthesis with resultant significant central spinal stenosis and significant bilateral (R>L) neural foraminal compromise. Mild bilateral facet effusion at this level is also noted.2.Tiny right far lateral disc protrusion at T2-L3 level without spinal stenosis or neural foraminal compromise as.3.Unremarkable images at other levels and without spinal stenosis or neural foraminal compromise.