Right lower extremity radicular pain, evaluate for herniated disc Please note for the purposes of numbering, there are 4 lumbar type vertebral bodies with hypoplastic ribs associated with T12 and a transitional segment below L4 labeled S1.Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position at the L1-L2 level.Mild degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Minimal disc bulge and facet arthropathy. No significant spinal canal stenosis. No significant neural foraminal stenosis.L3-L4: Disc desiccation and minimal bulge. There is moderate bilateral facet arthropathy. No significant spinal canal stenosis. There is mild to moderate bilateral, right greater than left, neural foraminal stenosis.L4-S1: There is right foraminal disc protrusion and advanced facet arthropathy, right worse in left. There is severe right neural foraminal stenosis and mild to moderate left neural foraminal stenosis.S1-2: Hypoplastic disc. No spinal canal or neural foraminal stenosis.Degenerative changes are noted at the bilateral sacroiliac joints. Paraspinous soft tissues are within normal limits.
1. Please note variant numbering with hypoplastic ribs associated with T12, 4 lumbar type vertebral bodies, and a transitional segment below L4 labeled S1 for the purposes of this study. As numbered, there is severe right-sided neural foraminal stenosis at the L4-S1 level related to foraminal disc protrusion and advanced facet arthropathy with suspected impingement of the exiting nerve root.2. No significant spinal canal stenosis at any level. Additional levels of neural foraminal narrowing as detailed above.