Clinical question: Evaluate left lumbar radiculopathy. Findings and symptoms: Back pain extending to left lower extremity, anesthesias. Nonenhanced lumbar MRI:The signal intensity of the vertebral column is unremarkable and the alignment remains anatomic.T12-L1 is unremarkable.L1-L2 is unremarkable.L2-L3 is unremarkable.L3-L4 demonstrate mild ligamentum flavum hypertrophy and unremarkable otherwise.L4-L5 demonstrate mild bilateral ligamentum flavum hypertrophy and unremarkable otherwise.L5-S1 demonstrate moderate disc disease and loss of T2 signal intensity and height and mild bilateral ligamentum flavum hypertrophy. There is a central and left para median shallow broad-based disc protrusion which is best appreciated on axial T2 series 6 image 37, axial T2 series 8 image 22 and 23. There is no spinal stenosis or neural foraminal compromise. Disc protrusion and mild hypertrophic changes of the left articulating facet and ligamentum flavum results in compromise of the left lateral recess and mass effect on the left S1 nerve root which is best appreciated on axial T2 series 8 on images 23 and 24.Unremarkable paraspinal soft tissues.
1.L5-S1 demonstrate a left lateral shallow broad-based disc protrusion which in combination with mild left facet and ligamentum flavum hypertrophy results in compromise of the left lateral recess and mass effect on the left S1 nerve root as detailed above.2.Essentially unremarkable nonenhanced lumbar MRI study otherwise.