Clinical question: Right-sided radiculopathy. Signs and symptoms: As above. Nonenhanced lumbar MRI:There is mild anterolisthesis at L5-S1 and exaggeration of lower lumbar lordosis.T11-T12 is unremarkable.T12-L1 demonstrate mild degenerative disease without spinal stenosis or neural foraminal compromise. L1-L2 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L2-L3 demonstrate mild degenerative changes, mild loss of disc height, moderate right and mild left ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. Constellation of changes results in mild central spinal stenosis and moderate bilateral (right greater than left) neural foraminal compromise.L4-L5 demonstrate mild disc disease, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. A tiny disc extrusion in the midline is present. No spinal stenosis however moderate bilateral neural foraminal compromise is present.L5-S1 demonstrate moderate disc disease and loss of disc height, moderate to severe right facet hypertrophic changes and including facet fusion and mild left facet degenerative changes. There is resultant mild grade 1 anterolisthesis at this level. No evidence of central spinal stenosis however moderate left and moderate to severe right neural foraminal compromise is present.
1.Degenerative changes at L3-L4 results in mild central spinal stenosis.2.Degenerative changes at L5-S1 in particular asymmetric significant right facet hypertrophic changes resulting in significant right and moderate left neural foraminal compromise and mild grade 1 anterolisthesis.3.No spinal stenosis at other levels however there are neural foraminal compromise as detailed per level above.