Low back pain, weakness, numbness in the left foot The vertebral bodies are appropriate in the overall alignment and height. The spinal cord has grossly normal signal characteristics and overall morphology. There is no compromise of the spinal cord.At the T9-T10 level, there is effacement of the posterior thecal sac related to ligamentum flavum thickening and/or facet arthropathy without evidence of high-grade spinal canal stenosis at this level.In the lumbar spine, there is disc desiccation at the L3-L4, L4-L5, and L5-S1 levels. There is developmental narrowing of the lumbar spinal canal with superimposed disc herniations/bulges with dorsal annular fissures at L4-L5 and L5-S1 contributing to severe spinal canal stenosis at these levels. There is mild facet arthropathy at these levels. There is also up to moderate narrowing of the neural foramina at these levels which can be better assessed with axial sequences. Upper lumbar spinal canal is patent.
This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No cord compression is identified.There is severe spinal canal stenosis at L4-L5 and L5-S1 related to combination of developmental narrowing and superimposed disc herniations/bulges. Recommend dedicated lumbar spine MRI for further evaluation.Dr. Ali discussed findings with Dr. Adjei-Twum in the ED at 0840 hours on 4/23/2016.