Radicular pain down the right leg. There are 6 nonrib-bearing lumbar-type vertebrae. As on the prior examination, the last disc space is labeled L6-S1. The vertebral column alignment is within normal limits. Mild degenerative endplate signal change is present at L4-5, L5-6 and L6-S1. The vertebral bone marrow signal is otherwise unremarkable. There is no significant spinal canal stenosis from L1-2 through L3-4. The imaged portion of the distal spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. Disc desiccation and mild loss of intervertebral disc height is unchanged at L4-5 through L6-S1. There are multilevel facet degenerative changes throughout the lumbar spine. At L4-5, there worsening of a now moderately-sized left paracentral disc protrusion and osteophyte complex, which is compromising the lateral recess and appears to contact the traversing left nerve root. At L5-6, there has been interval worsening of the moderately sized right paracentral to foraminal disc protrusion which compromises the lateral recess and appears to contact the traversing right nerve root at this level.
There are 6 lumbar type vertebrae. Moderately sized paracentral disc protrusions, which are new at the L4-5 level and worsened at the L5-6 level. These appear to contact the traversing nerve roots in the lateral recesses on the left at L4-5 and right at L5-6.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.