Clinical question: Low back pain. Signs and symptoms: Low back pain. Nonenhanced lumbar MRI:There is normal anatomical alignment of vertebral column.The signal intensity of the vertebral column demonstrate changes secondary to degenerative disease.Examination from T10-T11 through L2-L3 levels demonstrate no spinal stenosis or neural foraminal compromise and no significant degenerative disease.L3-L4 demonstrate advanced disc disease with significant loss of disc height, shallow broad-based bulging disc, mild to moderate bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis. Moderate to significant right neural foraminal compromise compromise secondary to hypertrophic changes of posterior elements as well as a small right lateral and far lateral disc protrusion. Patent left neural foramina.L4-L5 demonstrate advanced disc disease with significant loss of disc height, mild to moderate bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis. Bilateral moderate to severe neural foraminal compromise (left greater than right).L5-S1 demonstrate moderate disc disease and loss of disc height moderate bilateral ligamentum flavum hypertrophy as well as moderate left facet hypertrophy changes. Constellation of changes results in significant bilateral ( left greater than right) neural foraminal compromise. Unremarkable perispinal soft tissues. Unremarkable partially visualized SI joints.
1.Extensive degenerative changes primarily at L3-L4 through L5-S1 levels as detailed.2.No evidence of spinal stenosis.3.There are multilevel neural foraminal compromise (some significantly) in lower lumbar levels as detailed per level.