Clinical question: Evaluate for disc herniation. Signs and symptoms: Back and left leg pain. Nonenhanced lumbar MRI:T12-L1 is unremarkable.L1-L2 is unremarkable.L2-L3 is unremarkable with the exception of mild ligamentum flavum hypertrophy.L3-L4 demonstrate mild ligamentum flavum hypertrophy and mild left facet effusion. There is a right lateral and far lateral broad-based disc protrusion with resultant significant compromise of right neural foraminal and mass effect with displaces of the right L3 nerve root beyond the neural foramen. There is also compromise of the right lateral recess of the canal at this level. This finding is best appreciated on axial T2 series 7 image 25, axial T2 series 9 image 13). There is no central spinal stenosis and the left neural foramen remains patent.L4-L5 demonstrate moderate disc disease and loss of disc height, mild bilateral facet and ligamentum flavum hypertrophy without central spinal stenosis. There is a disc osteophyte complex on the left with resultant left lateral recess compromise and without neural foraminal or spinal stenosis.L5-S1 demonstrate a left lateral disc protrusion with resultant left lateral recess compromise and mass effect/posterior displacement of left S1 nerve root. No central spinal stenosis or neural foraminal compromise.
1.At L3-L4 level there is a right lateral and far lateral broad-based protrusion with compromise of right lateral recess, significant compromise of right neural foraminal without spinal stenosis as detailed.2.At L4-L5 there is a broad-based left-sided disc and osteophyte complex resulting in left lateral recess compromise without spinal stenosis or neural foraminal compromise.3.At L5-S1 there is a left-sided broad-based disc protrusion with mass effect on the left lateral recess and left S1 nerve root.4.Mild degenerative changes at other levels. Please review detailed report per level above.