Clinical question: Reason for low back and bilateral leg pain. Signs and symptoms: Symptoms of lumbar spinal stenosis. Nonenhanced lumbar MRI:Lower most visualized thoracic spine and thoracic cord from T9 inferiorly demonstrate no pathology.T12-L1 is unremarkable with the exception of mild degenerative changes.L1-L2 demonstrate moderate disc disease, loss of disc height and moderate bilateral ligamentum flavum and mild facet hypertrophy. No spinal stenosis or neural foraminal compromise.L2-L3 demonstrate mild disc disease and loss of disc height, moderate bilateral ligamentum flavum and mild facet hypertrophic changes. No spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild disc disease with loss of disc height, mild broad-based bulging disc, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. Constellation of findings result in mild central spinal stenosis and moderate right neural foraminal compromise. There is a central and right paramedian tiny annular fissure present.L4-L5 demonstrate mild to moderate disc disease and loss of disc height, broad-based bulging disc, moderate bilateral ligamentum flavum and facet hypertrophic changes. Findings result in mild central spinal stenosis, moderate left neural foraminal and lateral recess and mild to moderate right neural foraminal compromise.L5-S1 demonstrate moderate disc disease, loss of disc height, moderate ligamentum flavum and mild facet hypertrophic changes. No spinal stenosis, mild bilateral neural foraminal compromise.Unremarkable. Spinal soft tissues.
1.Degenerative changes at L3-L4 and L4-L5 levels with resultant mild central spinal stenosis.2.Mild to moderate neural foraminal and lateral recess compromise as detailed per level above.