Clinical question: Stenosis? Signs and symptoms: RLE pain. Nonenhanced lumbar MRI:T12 -- L1 is unremarkable.L1 -- L2 demonstrate mild disk disease and loss of disk height and mild bilateral facet and ligamentum flavum hypertrophy. No central spinal stenosis however a moderate bilateral neural foraminal compromise is noted.L2 -- L3 demonstrate moderate disk disease and loss of disk height, moderate bilateral facet and ligamentum flavum hypertrophy and resultant moderate central spinal stenosis and significant left and moderate right neural foraminal compromise. There is a large left lateral disk extrusion with inferior migration behind the vertebral body of L3 contributing to spinal stenosis posterior to L3 vertebrae.L3 -- L4 demonstrate moderate disk disease, loss of disk height, significant facet and moderate ligamentum flavum hypertrophy bilaterally. Degenerative changes results in grade 1 anterolisthesis and pseudo-bulge of the disk. There is resultant significant central spinal stenosis and bilateral neural foramina compromise.L4 -- L5 demonstrate advanced disk disease with loss of disk height, moderate bilateral facet and ligamentum flavum hypertrophy and grade 1 anterolisthesis. There is resultant significant central spinal stenosis and moderate to significant bilateral neural foraminal compromise (right greater than left).L5 -- S1 demonstrate mild degenerative disk disease and moderate facet hypertrophy without significant ligamentum flavum hypertrophy. There is no central spinal stenosis or neural foraminal compromise. The paraspinal soft tissues are unremarkable.
1.Degenerative changes at L2 -- L3 and including a left lateral disk extrusion with inferior migration is noted. Findings results in moderate central spinal stenosis and neural foraminal compromise.2.Extensive degenerative disk disease at L3 -- L4 results in mild grade 1 retrolisthesis, significant central spinal stenosis and neural foraminal compromise.3.Advanced degenerative changes at L4 -- L5 with resultant grade 1 anterolisthesis and significant central spinal stenosis and bilateral neural foraminal compromise.