Clinical question: Low-back pain neck pain. Signs and symptoms: As above. Nonenhanced lumbar MRI:T11-T12 demonstrate mild degenerative disc disease and a small shallow central disc protrusion without spinal stenosis or neural foraminal compromise. There are no axial images through the level.T12-L1 is unremarkable.L1-L2 is unremarkable.L2-L3 demonstrate mild hypertrophic changes of facets and ligamentum flavum and unremarkable otherwiseL3-L4 demonstrate mild disc desiccation, mild to moderate bilateral facet and ligamentum flavum hypertrophy without spinal stenosis or neural foraminal compromise.L4-L5 demonstrates mild disc desiccation, mild to moderate bilateral facet and ligamentum flavum hypertrophy constellation of changes and including slight prominence of dorsal epidural fat pad results in mild central spinal stenosis without neural foraminal compromise.L5-S1 demonstrate advanced disc disease, significant loss of disc height, moderate to severe left and moderate right facet hypertrophic changes and mild right ligamentum flavum hypertrophy. There is evidence of a prior left sided laminectomy with resultant expansion of thecal sac. No spinal stenosis and no convincing evidence of neural foraminal compromise.Incidental note is made of a well demarcated single locule cyst of the posterior aspect of right kidney measuring 21 x 20 mm in transaxial dimensions and 2 additional foci of T2 hyperintensity within the right kidney measuring at 5.5 and 3.7 which could represent cyst. Unremarkable paraspinal soft tissues otherwise.The lower most visualized thoracic cord, conus and cauda equina remain unremarkable
1.Advanced degenerative disc disease at L5-S1 without spinal stenosis or neural foraminal compromise. Evidence of prior left-sided laminectomy at this site.2.Mild degenerative changes at other levels.3.Mild central spinal stenosis only at L4-L5 level.4.No evidence of neural foraminal compromise at any level.