Clinical question: Explanation for back pain. Signs and symptoms: L3, L4 radiculopathy. Nonenhanced lumbar MRI:There is normal anatomical alignment of vertebral column however with slight straightening of lordosis.T11-T12, T12-L1 and L1-L2 levels are unremarkable.L2-L3 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise. Minimal bilateral facet effusion is noted.L3-L4 demonstrate moderate disc disease and loss of disc height, mild bilateral facet and ligamentum flavum hypertrophy without spinal stenosis or neural foraminal compromise.L4-L5 demonstrate moderate disease and loss of disc height, moderate bilateral ligamentum flavum and mild bilateral facet hypertrophic changes. Mild right-sided facet effusion. There is a shallow broad-based left lateral and far lateral disc protrusion with resultant moderate left neural foraminal compromise (sagittal T1 and T2 images for through 8). No spinal stenosis and patent left neural foramina.L5-S1 demonstrate moderate disc disease and loss of disc height and mild bilateral facet and ligamentum flavum hypertrophy. No spinal stenosis and only mild right neural foraminal compromise.
1.Shallow broad-based left lateral and far lateral disc protrusion at L4/L5 with resultant moderate left neural foraminal compromise and without spinal stenosis.2.Degenerative changes at other levels without spinal stenosis at any level. Neural foraminal compromise as detailed per level above.