Clinical question: Stenosis. Signs and symptoms: Sciatica. CT of lumbar spine:The alignment of the vertebral column is anatomical.T12 -- L1.Minimal degenerative changes and unremarkable otherwise.L1 -- 2.Minimal degenerative changes and unremarkable otherwise.L2 -- L3.Minimal degenerative changes and unremarkable otherwise.L3 -- L4.There is mild degenerative disk disease and minimal hypertrophic changes of posterior elements.There is asymmetric midline and leftward disk protrusion with resultant mass effect and posterior displacement of thecal sac. No convincing evidence of central trauma stenosis however mild lateral recess compromise bilaterally is noted. Minimal bilateral neural foraminal compromise is also present.L4 -- L5.Advanced degenerative disk disease with significant loss of disk height and mild hypertrophic changes of posterior elements are present. There is shallow broad based bulge of disk slightly more prominent on the right. No central spinal stenosis. Very minimal bilateral neural foramina (right greater than left) is present.L5 -- S1.Minimal degenerative changes. No central spinal stenosis. Minute bilateral neural foraminal compromise secondary to hypertrophied changes of ligamentum flavum present.
1.No convincing evidence of central spinal stenosis at any level.2.Broad base disk protrusion in the midline and to the left however at L3--L4 results in subtle mass effect on the thecal sac at this level.3.Advanced degenerative disk disease at L4 -- L5 level and mild disk disease at other levels.4.Minimal bilateral neural foraminal compromise at L3 -- L4, L4 -- L5 (right greater than left) and L5 -- S1 levels are present.