Diagnosis: LumbagoClinical question: Pt with bilateral shooting leg pain and back pain; please eval for spinal stenosis or herniated diskSigns and Symptoms: back pain, leg pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is right-sided facet hypertrophy present at this level resulting in some minimal displacement of the nerve root at the right lateral recess.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is mild disc desiccation at this level. There is bilateral facet hypertrophy at this level right more than left with some mild displacement of the nerve root in the right lateral recessAt L3-4 there is no significant compromise to spinal canal or neural foramina. There is mild to moderate disc desiccation at this levelAt L2-3 there is no significant compromise to spinal canal or neural foramina. There is some facet hypertrophy present on the right side at this level associated ligamentum flavum hypertrophy and some mild encroachment of the right-sided exiting nerve root within the neural foramen.At L1-2 there is no significant compromise to spinal canal or neural foramina.The left kidney was not identified. There is metal artifact present at the expected location of the left kidney suggesting prior removal of the left kidney.There is atrophy of the right paraspinous musculature in the lower lumbar spine. This finding is been present on prior exams dating back to at least 2011.
There is some mild encroachment of right-sided exiting nerve roots at L3-4 and to a lesser degree L4-5 due to dominant right sided facet hypertrophy. The nerve roots at the right lateral recess are displaced by a facet hypertrophy.