Clinical question: Numb and painful feet, loss of vibratory sense, former football player. Signs and symptoms: Has 4 fused vertebrae. Nonenhanced lumbar MRI:Please note that the numbering of the lumbar vertebral levels is performed utilizing prior cervical and thoracic MRI images for accuracy.T12 -- L1 is unremarkable with the exception of degenerative changes.L1 -- L2 it is unremarkable other than mild degenerative changes.L2 -- L3 demonstrate moderate disk disease and loss of disk height, mild bilateral facet and ligamentum flavum hypertrophy. There is a right lateral disk osteophyte complex with resultant significant right lateral recess compromise and mild right neural foraminal compromise. There is mild central spinal stenosis.L3 -- L4 demonstrate moderate disk disease and loss of disk height, moderate left facet and ligamentum flavum hypertrophy and mild on the right. Asymmetric left-sided hypertrophy changes of posterior elements and in combination with a small disk osteophyte complex on the left results in significant left lateral recess and moderate left neural foraminal compromise. Mild to moderate central spinal stenosis and moderate right neural foraminal compromise is also noted.L4 -- L5 demonstrate mild disk disease and loss of disk height, mild bilateral facet and ligamentum flavum hypertrophy is present. There is no evidence of central spinal stenosis. There is however significant bilateral neural foraminal compromise secondary to degenerative changes.L5 -- S1 demonstrate mild disk desiccation without loss of disk height, moderate bilateral facet and ligamentum flavum hypertrophy. There is no central spinal stenosis. There is however moderate bilateral neural foramina compromise.Lowermost visualized thoracic spine and cord is unremarkable.Unremarkable perispinal soft tissues.
1.Degenerative changes of lumbar spine results in mild central spinal stenosis at L2 -- L3 and moderate at L3 -- L4 levels.2.Multilevel bilateral neural foraminal and lateral recess compromise as detailed per level.3.Unremarkable lowermost visualized thoracic spine and cord other than mild degenerative changes.