Clinical question: Neurogenic claudication. Signs and symptoms: Neck pain. Nonenhanced lumbar MRI:T11-T12 is unremarkable.T12-L1 is unremarkable.L1-L2 is unremarkable.L2-L3 demonstrate minimal degenerative changes and unremarkable otherwise.L3-L4 demonstrate mild bilateral ligamentum flavum and facet hypertrophy. Minimal bilateral facet effusion is noted. No spinal stenosis or neural foraminal compromise.L4-L5 demonstrate moderate disc disease and loss of disc height, diffuse T2/T2 STIR hyperintensity of the endplates and vertebral bodies, bilateral ligamentum flavum hypertrophy, significant bilateral facet space widening with fluid signal intensity consistent with facet effusion. Constellation of above changes results in mild central spinal stenosis and significant bilateral neural foraminal compromise. Above described T2 hyperintensity of the adjacent endplates and vertebral body at this level are believed to be secondary to extensive degenerative disease. Likelihood of an infectious process is considered low and follow-up exam is recommended after conservative treatment for further assessment.L5-S1 demonstrate mild disc desiccation, mild bilateral facet and ligamentum flavum hypertrophy without spinal stenosis or neural foraminal compromise. A tiny annular fissure in the midline is detected.
1.Extensive degenerative changes at L4-L5 with resultant significant bilateral neural foraminal compromise and mild central spinal stenosis as detailed. Please review report above and recommendation for follow-up.2.Mild degenerative changes at other levels without spinal stenosis or significant neural foraminal compromise. Please see detailed report per level above.