Clinical question: Assess disc herniation and stenosis. Signs and symptoms: LLE pain. Nonenhanced lumbar MRI:The signal intensity of the vertebral column demonstrate changes secondary to degenerative disease and unremarkable otherwise.T11-T12 is unremarkable.T12-L1 is unremarkable.L1-L2 demonstrate minimal degenerative changes and unremarkable otherwise.L2-L3 demonstrate mild disc disease, mild bilateral ligamentum flavum hypertrophy and mild facet disease including bilateral facet effusion. No spinal stenosis and only mild neural foraminal compromise is present. A previously noted far right lateral annular fissure is no longer appreciated and presumed healed.L3-L4 demonstrate mild disc disease, mild to moderate bilateral ligamentum flavum hypertrophy and mild facet disease with facet effusion. There is no central spinal stenosis however mild left and moderate right neural foraminal compromise is present. There is no significant change since prior exam.L4-L5 demonstrate mild disc disease, moderate bilateral ligamentum flavum hypertrophy and mild to moderate bilateral facet disease and mild hypertrophy. There is resultant mild grade 1 anterolisthesis. There is no significant change since prior exam. There is however interval complete resolution of previously noted right lateral disc protrusion. No central spinal stenosis however moderate to severe right neural foraminal and right lateral recess compromise is again noted similar to prior study.L5-S1 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise or any significant change since prior exam.
1.Mild to moderate degenerative changes of lumbar spine and including mild grade 1 anterolisthesis at L4-L5 without significant change since prior exam.2.Interval complete resolution of a right lateral large disc protrusion at L4-L5 since prior study.3.No central spinal stenosis at any level. Moderate to severe right neural foraminal compromise at L4-L5 secondary to degenerative changes without significant change since prior exam and mild neural foraminal compromise at other levels as detailed.4.Incidental note is made of multiple bilateral renal cysts with subtle interval increased size since prior study.