Clinical question: Assess for disk herniation. Signs and symptoms: Low back pain. Nonenhanced lumbar MRI:There is normal anatomical alignment of vertebral column.The marrow signal intensity of vertebral column demonstrate changes secondary to mild degenerative disease and unremarkable otherwise.T12 -- L1 is unremarkable.L1 -- L2 is unremarkable.L2 -- L3 demonstrate mild to moderate disk disease and loss of disk height and mild to moderate bilateral ligamentum flavum hypertrophy. There is a tiny centrally located disk protrusion with resultant subtle indentation of thecal sac however without spinal stenosis or neural foraminal compromise.L3 -- L4 demonstrate mild disk disease and loss of disk height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. There is a broad based shallow central and rightward disk protrusion with resultant slight flattening and posterior displacement of thecal sac on the right. There is no neural foraminal compromise however mild right lateral recess compromise is detected. No central spinal stenosis.L4 -- L5 demonstrate moderate bilateral ligamentum flavum hypertrophy and without evidence of disk disease, central spinal stenosis or neural foraminal compromise.L5 -- S1 demonstrate moderate disk disease and loss of disk height, mild bilateral ligamentum flavum hypertrophy and no appreciable facet disease. There is a right paramedian shallow disk protrusion present at this level. No central spinal stenosis. Mild right neural foraminal compromise secondary to degenerative changes. Unremarkable lowermost visualized thoracic spine and thoracic cord from T10 inferior. Unremarkable perispinal soft tissues.
1.Normal anatomical alignment the vertebral column and without evidence of fracture.2.Multi-level shallow disk protrusions at L2 -- L3, L3 -- L4 and L5 -- S1 levels as detailed.3.There is no evidence of central spinal stenosis at any level. 4.Mild right neural foraminal compromise at L5 -- S1 on the right and patent at all other levels. Mild right lateral recess compromise at L3 -- L4.5.Please review detailed report per level above.