Diagnosis: Thoracic or lumbosacral neuritis or radiculitis, unspecifiedClinical question: assess for progression of lumbar stenosisSigns and Symptoms: claudication Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact. The patient is status post laminectomies at L1, L2, L3, L4 and L5. There is mild left lateral translation of L3 on L4. There is redemonstration of a 22 x 17 mm T1 hyperintense well-circumscribed lesion within the T12 vertebral body along its right posterior aspect. The signal intensity suppresses on the fat suppressed images. Most likely this represents a vertebral body hemangioma and remains stable.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy present at this level. There is some mild enhancement adjacent to the nerve root at the left lateral recess at this level. This is stable compared to the prior exam.At L4-5 there is no significant compromise to spinal canal. There is loss of disc space height present at this level associated with Schmorl's node and a disc bulge as well as some chronic endplate reactive changes. The exiting nerve roots within the right neural foramen are surrounded by fat whereas the fat surrounding exiting nerve roots within the left neural foramen is effaced. There is facet hypertrophy present on the left side at this level and some ligamentum flavum hypertrophy bilaterally. This is stable compared to the prior exam.At L3-4 there is no significant compromise to spinal canal. There is loss of disc space height, disc desiccation and a mild disc bulge associated with endplate reactive changes at this level. The fat surrounding the exiting nerve roots within the neural foramina bilaterally isn't effaced. There is left lateral translation of L3 on L4. This is stable compared to the prior exam.At L2-3 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and disc bulge at this level associated with some endplate osteophytes and some mild narrowing of the neural foramina. There is a right far lateral disc protrusion present this level which displaces the right-sided exiting nerve root after it exits the neural foramen. This is stable compared to the prior exam.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation, endplate reactive changes and a disc bulge at this level.There are disc bulges also present at T12-L1, T11-T12 and T10-T11 which are also stable.
1.The patient is status post multilevel laminectomies in the lumbar spine since the 2006 exam. There is neural foramina encroachment of the exiting nerve roots due to degenerative changes present on the left side at L4-5 and bilaterally at L3-4. This neural foramina encroachment is stable.