66 years Male (DOB:3/6/1949)Reason: known HNP L4-5 pain resolved over 6 months with PT but he is left with EHL weakness and hamstring weakness. History: compare to previous MRI for disc material still present. Is surgery still an option to resolve weakness??PROVIDER/ATTENDING NAME: BEN-ZION ROITBERG BEN-ZION ROITBERG 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. There is multilevel disc desiccation present. Overall the patient's lumbar spinal canal is relatively small on a congenital basis. The pedicles are thickened short .At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a disc bulge present at this level associated with mild narrowing of the right neural foramen.At L4-5 there is a central disc protrusion present with disc material extending behind the adjacent endplates which compresses the thecal sac and effaces the fat at the lateral recess is bilaterally. Some disc material extends into the inferior aspects of the neural foramina. The exiting nerve roots within the neural foramina are surrounded by fat. Overall there is a moderate to severe degree of spinal stenosis present. Compared to prior exam this has not changed substantially.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is a diffuse disc bulge present at this level. Overall there is mild degree are spell stenosis at this level. Some disc material extends into the inferior aspects of the neural foramina. The exiting nerve roots within the neural foramina are surrounded by fat. At L2-3 there is no significant compromise to spinal canal or neural foramina. There is a diffuse disc bulge present at this level. Some disc material extends into the inferior aspects of the neural foramina. The exiting nerve roots within the neural foramina are surrounded by fat. At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There are multilevel degenerative changes present lumbar spine worse at L4-5 where there is spinal stenosis resulting from disc extrusion. This appears stable compared to prior exam from July.