Clinical question: Evaluate for stenosis. Signs and symptoms: Pain. Nonenhanced lumbar MRI:Lower most visualized thoracic spine and thoracic cord is unremarkable.T12-L1 is unremarkable.L1-L2 demonstrate mild degenerative changes and unremarkable otherwise.L2-L3 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild degenerative disc disease, moderate bilateral ligamentum flavum hypertrophy and mild facet hypertrophy. No spinal stenosis and mild left neural foraminal compromise.L4-L5 demonstrate moderate disc disease, moderate bilateral ligamentum flavum hypertrophy and severe hypertrophic changes of bilateral articulating facets with resultant new grade 1 anterolisthesis. The findings at this level demonstrates significant interval progression and the anterolisthesis is a new finding since prior exam. Findings results in mild central spinal stenosis, significant right and mild left neural foraminal compromise. There is T2 increased signal intensity within the right articulating facet at this level suggestive of facet effusion. There is a tiny retention cyst at this level projecting in the inferior lateral aspect of the right neural foramina (axial T2 series 8 image 19 and sagittal T2/T2 STIR image 12). Small synovial cyst is also noted projecting posterior to the right articulating facet at this level (axial T2 series 7 image 9 and sagittal T2/T2 STIR image 11).L5-S1 demonstrate mild disc disease, moderate left and mild right facet hypertrophic changes and mild ligamentum flavum hypertrophy. No central spinal stenosis or neural foraminal compromise.
1.Since prior exam there is progression of degenerative changes at L4-L5 level and including new grade 1 anterolisthesis. There is mild central spinal stenosis, significant right and mild left neural foraminal compromise as detailed. Tiny right-sided synovial cyst projecting in inferior lateral aspect of the right neural foramina and a slightly larger synovial cyst projecting posterior to the right articulating facet at this level.2.Mild degenerative changes at other levels however without evidence of central spinal stenosis or any significant neural foraminal compromise. Please see detailed report per level above.