Clinical question: History spinal stenosis from spinal cyst. Signs and symptoms: No like pain and stiffness, hard to bend over. Nonenhanced lumbar MRI:T11 -- T12 is unremarkable.T12 -- L1 is unremarkable.L1 -- L2 demonstrate mild disk disease and loss of disk height and mild bilateral (left greater than right) facet and ligamentum flavum hypertrophy. There is a left far lateral small disk protrusion (sagittal T2/T2 stir image 6 and axial T2 series 701 image 32 and 33). Finding resulting subtle mass effect on the thecal sac on the left and extends into the left neural foramina with resultant mild compromise of the inferior aspect of neural foraminal. No spinal stenosis.L2 -- L3 moderate disk disease and loss of disk height with interval progression since prior study. Moderate bilateral facet and ligamentum flavum hypertrophy changes are also present. There is redemonstration of a right-sided synovial cyst with mass effect and forward and leftward displacement of thecal sac and moderate central spinal stenosis. The cyst appears to partially herniate through the ligamentum flavum. It however demonstrate slight interval decreased size since prior to study. There is mild right neural foraminal compromise secondary to degenerative changes with slight interval progression since prior exam from 2010.L3 -- L4 demonstrate moderate disk disease and loss of disk height and mild bilateral (left greater than right) facet and ligamentum flavum hypertrophy. No spinal stenosis or neural foraminal compromise. No significant change since prior exam.L4 -- L5 demonstrate advanced disk disease and significant loss of disk height, moderate left and mild right facet and ligamentum flavum hypertrophy. No spinal stenosis or neural foraminal compromise.L5 -- S1 demonstrate moderate advanced disk disease and loss of disk height and mild bilateral facet and ligamentum flavum hypertrophy. No significant change since prior exam. No spinal stenosis or neural foraminal compromise.
1.Extensive degenerative changes of lumber spine with mild interval progression since prior study from 2010.2.Extensive degenerative changes at L2 -- L3 with subtle interval progression. Interval decreased size of a right-sided synovial cyst however with persistent central spinal stenosis and significant right lateral recess compromise as detailed.3.At L1 -- L2 there is a left-sided lateral and far lateral shallow disk protrusion with subtle mass effect on the thecal sac and mild compromise of the lower aspect of the left neural foramina as detailed above.