Clinical question: 60-year-old female with left lateral leg and foot numbness that courses with walking. Eased with sitting. Mild back pain. Signs and symptoms: Back pain, left leg radicular symptoms. Nonenhanced lumbar MRI:Examination at T11-T12 through L2-L3 levels are unremarkable with the exception of mild degenerative changes.L3-4 demonstrate moderate disc disease and loss of disc height, and mild bilateral (right greater than left) facet and ligamentum flavum hypertrophy. There is a far lateral broad-based shallow disc protrusion on the right with resultant mild right neural foraminal and lateral recess compromise. No spinal stenosis.L4-L5 demonstrate mild disc disease and loss of disc height, shallow asymmetric right-sided lateral and far lateral bulging disc with resultant moderate right neural foraminal compromise without central spinal stenosis and patent left neural foramina.L5-S1 demonstrate moderate disc disease and loss of disc height, moderate left and mild right facet hypertrophy changes and mild bilateral ligamentum flavum hypertrophy. There is no central spinal stenosis however severe left neural foraminal and mild left lateral recess compromise is present. Right neural foramina remains patent.Visualized SI joints demonstrate no significant degenerative changes.There is spinal soft tissues are unremarkable.
1.Degenerative changes of lumbar spine primarily at L5-S1 level and to a lesser degree at L4-L5 and L3-4 levels are present.2.There is no evidence of central spinal stenosis at any level.3.Multilevel neural foraminal and lateral recess compromise as detailed per level above.