Assess for spinal stenosis. Pain and hyperreflexia. Nonenhanced lumbar MRI:T12 -- L1 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise. Large left-sided adrenal cyst is noted.L1 -- L2 demonstrate mild degenerative changes without central spinal stenosis or neural foraminal compromise.L2 -- L3 demonstrate mild degenerative changes without central spinal stenosis. Mild bilateral neural foraminal compromise is present.L3 -- L4 demonstrate mild disk disease and moderate (left greater than right) facet and ligamentum flavum hypertrophy. Findings results in moderate left and mild right neural foraminal compromise and no central spinal stenosis.L4 -- L5 demonstrate moderate disk disease, mild loss of disk height and extensive (left greater than right) facet and ligamentum flavum hypertrophic changes. There is resultant significant central spinal stenosis with significant bilateral (right greater than left) foraminal compromise.There is a small left-sided synovial cyst projecting laterally from the left facet complex immediately at the level of the left neural foramina which contribute to compromise of the left neural foramina. This finding is best appreciated on axial T2 series 1401 on image 15 and sagittal T2/T2 stir image 5.L5 -- S1 demonstrate mild chronic compression deformity of the superior endplate of L5 (new since prior exam), mild disk disease and moderate left and mild right facet and ligamentum flavum hypertrophy. No spinal stenosis however left neural foramina compromise of moderate degree is noted.Compared to prior exam there is interval progression of degenerative changes and including progression of central spinal stenosis at L4 -- L5 as detailed.
1.Examination of the L4 -- L5 demonstrate extensive degenerative changes mostly of the posterior elements with resultant significant central spinal stenosis and neural foraminal compromise as detailed. There is interval progression of disease since prior study.2.Degenerative changes at other levels however none with significant central spinal stenosis. Multilevel neural foraminal compromise as detailed per level.