Diagnosis: Radiculopathy, lumbar regionClinical question: lumbar radiculopathySigns and Symptoms: right sciatica Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. There are some Tarlov's cysts present in the sacral spinal canalAt L5-S1 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with bilateral facet hypertrophy and ligamentum flavum hypertrophy. There is fluid within the facet joints with some widening of the facet joints. The fat at the lateral recess is effaced bilaterally but worse on the right versus the left side. It is encroachment of the nerve roots at the lateral recesses sees worse on the right side than the left. There is mild narrowing of the neural foramina bilaterally with some mild encroachment of the right-sided exiting nerve roots within the neural foramina. There are some endplate reactive changes present at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is moderate bilateral facet and ligamentum flavum hypertrophy at this level. A small amount of fluid is present in the facet jointsAt L3-4 there is no significant compromise to spinal canal or neural foramina. There is a mild degree of facet and ligamentum flavum hypertrophy at this level.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There are degenerative changes present in lumbar spine worse at L5-S1 where there is encroachment of the nerve roots at the lateral recesses sees bilaterally but worse on the right side versus the left and also encroachment of the right-sided exiting nerve roots.