74-year-old male with L5 lumbar radiculopathy. Evaluate for spinal stenosis or a herniated disk. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is multilevel disc desiccation. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. Degenerative changes are seen in the cervical spine as described below:T12-L1: There is no significant compromise to spinal canal or neural foramina.L1-L2: There is no significant compromise to spinal canal or neural foramina.L2-L3: There is a minimal disc bulge with mild to moderate facet hypertrophy and ligamentum flavum thickening but no significant neuroforaminal narrowing or central spinal canal stenosis.L3-L4: There is a minimal disc bulge and mild-to-moderate facet hypertrophy and ligamentum flavum thickening but no significant neural foraminal stenosis. There is mild central spinal canal stenosis.L4-5: There is a disc bulge, right greater than left facet hypertrophy, and ligamentum flavum thickening which causes mild to moderate central spinal canal stenosis and narrows the right neural foramina, which encroaches on the exiting right L4 nerve root.L5-S1: There is a disc bulge as well as facet hypertrophy and ligamentum flavum thickening but no significant compromise of spinal canal or neural foramina.
Multilevel degenerative changes of the lumbar spine most prominent at the L4-5 level where there is mild to moderate central spinal canal stenosis and narrowing of the right neural foramina which encroaches on the exiting right L4 nerve root in the neural foramen.