Lower back pain with numbness and weakness of left leg The vertebral bodies are appropriate in the overall height. There is grade 1 retrolisthesis of L5 on S1. There is straightening of the cervical and lumbar curvature. Again seen is diffuse T1 hypointense marrow signal which is nonspecific and can be seen in entities such as chronic anemias. No obvious cord signal abnormality. No evidence of cord compression. Spinal canal and neural foramina at the L1-L2, L2-L3, and L3-L4 are grossly preserved. At L4-L5, there is a left foraminal/extraforaminal protrusion with mass effect on the exiting left L4 nerve root similar to prior. At L5-S1 again seen is a large right paracentral disc extrusion with effacement of the lateral recesses, right worse than left, with mass effect on the S1 nerve roots.
This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No cord compression is identified.Additional axial sequences of the lumbar spine again demonstrate an L5-S1 disc extrusion with effacement of the lateral recesses, right greater than left, similar to prior. Left-sided disc protrusion at the L4-L5 level with suspected impingement of the left L4 nerve root is also grossly similar to prior. Complete follow-up lumbar spine MRI can be considered for further evaluation as clinically indicated.