Diagnosis: Other intervertebral disc degeneration, lumbar region Other intervertebral disc degeneration, lumbar regionClinical question: Low back pain, evaluate for nerve root compression/ disc diseaseSigns and Symptoms: Low back pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is loss of disc space height, disc desiccation and a disc bulge associated with the bilateral ligamentum flavum hypertrophy and partial effacement of the fat at the lateral recess bilaterally which is worse on the left compared to the right side. Within the neural foramina, the exiting nerve roots are surrounded by fat.At L4-5 there is loss of disc space height, diffuse disc bulge, moderate bilateral facet and ligamentum flavum hypertrophy as well as mild anterior subluxation of L4 on L5. There is effacement of fat at the lateral recess bilaterally at this level and crowding of nerve roots. Overall there is moderate spinal stenosis at this level. Within the neural foramina, the exiting nerve roots are surrounded by fat.At L3-4 there is mild loss of disc space height, disc desiccation and diffuse disc bulge associated with mild ligamentum flavum hypertrophy. The fat at the lateral recess is not effaced at this level. Within the neural foramina, the exiting nerve roots are surrounded by fat.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There are endplate reactive changes present anteriorly at T12-L1 and T11-T12. The endplate reactive changes at T12-L1 are high signal on T2 and low signal on T1 transient endplate reactive changes at T11-T12 are high signal on T1.There is a large cystic lesion present in the left kidney measuring up to 6 cm in size which is not entirely included on this exam. Additional cystic lesions are present in the right kidney measuring up to 10 mm diameter which most likely represent simple cysts.
1.There are multilevel degenerative changes present in the lumbar spine with associated moderate spinal stenosis at L4-5 and encroachment of the nerve roots at the lateral recess at L5-S1.2.There are some subacute endplate reactive changes at T12-L1.3.There is a large cystic lesion present in the left kidney. Additional imaging may help further evaluate this since it is not entirely included on this exam.