Female 48 years old Reason: Back pain with sciatica, no response to conservative treatment History: left sided sciatica Five lumbar type vertebral bodies are presumed to be present. The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are well-maintained. There is diffuse decreased T1 bone marrow signal. There is more discrete decreased T1 and T2 signal in L1 vertebral body extending into the pedicles. There is a small amount of free pelvic fluid, which is likely physiologic. Presumed nabothian cysts in the cervix are incidentally noted.T12-L1: There is no significant compromise to spinal canal or neural foramina.L1-L2: There is no significant compromise to spinal canal or neural foramina.L2-L3: There is no significant compromise to spinal canal or neural foramina.L3-L4: There is no significant compromise to spinal canal or neural foramina.L4-5: There is no significant compromise to spinal canal or neural foramina.L5-S1: There is an ovoid lesion in the left lateral recess with mass effect on the left S1 nerve root which remains in contact with the L5-S1 disc, suspected to represent a disc extrusion with inferior migration. Central spinal canal and neural foramina at this level are otherwise patent.
1.Ovoid lesion at the left L5-S1 level suspected to represent a disc extrusion. There appears to be impingement of the left S1 nerve root. 2.Diffusely decreased bone marrow signal is nonspecific but can be seen with marrow reconversion related to chronic anemia for example as well as lymphoproliferative disorders. 3.Discrete T1 and T2 hypointense lesion involving the L1 vertebral body extending into the pedicles which is suspicious for sclerotic lesion; neoplastic involvement cannot be excluded. Further evaluation with CT is recommended. No associated compression fracture or soft tissue or epidural extension.Findings emailed to Dr. Cifu on 4/15/2016.