Clinical question: Evaluate lumbar stenosis or lumbar disc disease. Signs and symptoms: RLE radiculopathy and hip pain. Nonenhanced lumbar MRI:Lower most visualized thoracic spine from T10 inferiorly demonstrate no spinal stenosis and with normal signal intensity of the cord.T12-L1 demonstrate mild degenerative changes and unremarkable otherwise. No significant change since prior exam.L1-L2 demonstrate moderate disc disease, subtle loss of disc height, shallow broad-based bulging disc and mild bilateral facet and ligamentum flavum hypertrophy. No spinal stenosis or neural foraminal compromise. No significant change since prior exam.L2-L3 demonstrate mild degenerative changes and unremarkable otherwise and no significant change since prior study.L3-L4 demonstrate moderate disc disease and loss of disc height, significant bilateral ligamentum flavum hypertrophy and moderate bilateral facet hypertrophic changes (left greater than right). There is also mild grade 1 anterolisthesis at this level. Findings results in central spinal stenosis. The AP diameter of thecal sac at this level measures 8 mm compared to prior study measurement of 8.2 mm. There is moderate to severe left and mild to moderate right neural foraminal compromise. There is no significant change since prior exam.L4-L5 demonstrate moderate disc disease and loss of disc height, significant bilateral facet and left ligamentum flavum hypertrophy changes are present. There is evidence of a prior right-sided laminectomy at this level. There is resultant interval alleviation of central spinal stenosis at this level. There is a right lateral and far lateral broad-based disc protrusion with resultant significant right neural foraminal and right lateral recess compromise which is new since prior exam. Left neural foramina remains patent.L5-S1 demonstrate advanced disc disease and loss of disc height with interval progression since prior exam. Moderate bilateral facet hypertrophic changes and mild ligamentum flavum hypertrophy. No central spinal stenosis however moderate-to-severe right and mild to moderate left neural foraminal compromise is noted.
1.Interval right-sided laminectomy at L4-L5 and resolution of previously noted central spinal stenosis. Right lateral and far lateral disc protrusion with resultant significant right neural foraminal and right lateral recess compromise is a new finding since prior exam.2.Degenerative changes at L3-L4 and including mild grade 1 anterolisthesis results in central spinal stenosis without significant change since prior exam.3.Please review above detailed report per level.