Left lower extremity sciatica, worsening incontinence. There is a disc bulge at L4-5 with eccentric left annular fissure and apparently extruded or sequestered disc material measuring up to 8 mm in width in the left lateral recesses with impingement upon the nerve roots. In conjunction with bilateral facet hypotrophy and ligamentum flavum thickening at L4-5, there is also mild right and moderate left neural foraminal stenosis. There is also a disc bulge as well as facet hypertrophy and ligamentum flavum thickening at L5-S1 that collectively results in moderate spinal canal stenosis and mild to moderate bilateral neural foraminal stenosis. There is no significant spinal canal stenosis at the other lumbar spine levels. The imaged portions of the spinal cord are unremarkable. The vertebral body heights are preserved. The paravertebral soft tissues are unremarkable.
1. A disc bulge at L4-5 with eccentric left annular fissure and apparently extruded or sequestered disc material in the left lateral recesses impinges upon the nerve roots.2. A disc bulge as well as facet hypertrophy and ligamentum flavum thickening at L5-S1 that collectively results in moderate spinal canal stenosis and mild to moderate bilateral neural foraminal stenosis. 