Reason: herniated lumbar disc worsening low back and leg pain History: worsening low back and leg pain 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.At L5-S1 there is a broad-based central disk protrusion which impresses on the ventral aspect of the thecal sac and abuts the nerve roots of the lateral recesses bilaterally effaces the fat at the lateral recess is bilaterally. Compared to the prior exam this has not changed substantially. There is some loss of disk space height at this level.At L4-5 there is some loss of disk space height as well as a left lateral recess broad-based disk protrusion which encroaches on the nerve roots of the left lateral recess and to a lesser degree right lateral recess. The fat of the lateral recesses is effaced and bilaterally left more than right . Compared to the prior exam protrusion appears to have mildly regressed. Overall there is a moderate degree of spinal stenosis at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina.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 is a central disk protrusion present at L5-S1 which encroaches on the nerve roots of the lateral recesses - left more than right- and has not change substantially when compared to the previous exam.2.There is a broad-based left lateral recess disk protrusion at L4-5 which encroaches on the nerve roots of the left lateral recess and to a lesser degree right lateral recess which is subtly partially regressed since the prior exam. Overall there is moderate spinal stenosis at this level.