Right lower extremity radiculopathy. Assess for disc herniation. There are 5 lumbar-type, vertebrae. The last well-formed disc is L5-S1. Vertebral body heights in the lumbar spine are normal. Alignment is maintained. Bone marrow signal is benign. Six millimeter focal fat signal intensity in the left iliac bone may present a hemangioma. There is desiccation and mild-to-moderate height loss of the L4-L5 and L5-S1 discs. There are tiny Schmorl's nodes along the inferior endplates of T12 and L2 as well as the superior and inferior endplates of L3. The facets are normally aligned and and show no significant degenerative change.The tip of the conus medullaris lies at the lower L1 level. The conus medullaris has normal appearance and signal. The paravertebral tissues are unremarkable. Individual levels as below:T12-L1, L1-L2, L2-L3, and L3-L4: No disc herniation. No spinal canal or foraminal stenosis.L4-L5: Right paracentral disc protrusion with annular fissure results and effacement of the right lateral recess. No significant central canal stenosis. No neural foraminal stenosis.L5-S1: Central disc protrusion mildly effaces the lateral recesses and contacts the S1 nerve roots. No significant central canal stenosis. Neural foramina are patent.
1.There is a right paracentral disc protrusion at L4-L5 which may be impinging on the descending right L5 nerve root in the lateral recess.2.There is also a central disc protrusion at L5-S1 which contacts the bilateral descending S1 nerve roots.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.