Clinical question: Rule out facet arthropathy or spondylolysis. Signs and symptoms: Low back pain. Nonenhanced lumbar MRI:There is normal anatomical alignment of vertebral column.Lower most visualized thoracic spine and thoracic cord is unremarkable.T12-L1 is unremarkable.L1-L2 is unremarkable.L2-L3 demonstrate mild ligamentum flavum hypertrophy and mild facet disease. Minimal left facet effusion. No spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis or neural foraminal compromise.L4-L5 demonstrate mild disc disease and loss of disc height, mild bilateral ligamentum flavum hypertrophy and mild bilateral (L>R) facet degenerative/hypertrophic changes. There is a lateral and far lateral shallow disc protrusion on the left at this level with resultant moderate compromise of the left neural foramina and without intravenous of central spinal stenosis. There is mild to moderate right neural foraminal compromise is also noted. L5-S1 demonstrate mild to moderate disc disease and loss of disc height, mild bilateral ligamentum flavum hypertrophy and mild bilateral (R>L) facet degenerative changes. There is a shallow central and right para median disc protrusion with subtle indentation of thecal sac however without central spinal stenosis. Mild right neural foraminal compromise secondary to degenerative disease.
1.Mild to moderate degenerative changes (and including facets) of primarily the lower lumbar spine as detailed per level.2.No evidence of central spinal stenosis at any level.3.Left lateral/far lateral L4-L5 disc protrusion with resultant moderate left neural foraminal compromise.4.Small central and right paramedian shallow disc protrusion at L4-L5 without spinal stenosis.5.Other levels of neural foraminal compromise as detailed per level above.6.No significant facet arthropathy is detected. Please see above comments.