Reason: ? Disk herniation History: back pain with radiation to right lower abdomen 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 compressed grossly intact.At T12-L1 there is a large right paramedian disk extrusion present with disk material extruding behind the T12 vertebral body along its entire length. There is associated compression of the thecal sac and the conus medullaris. The extruded disk material is heterogeneous in signal characteristics. There is loss of disk space height and endplate reactive change at this level as well as signal change in the adjacent vertebral bodies. There is associated encroachment of the right-sided exiting nerve roots within the neural foramen at this level.At L5-S1 there is a diffuse disk bulge present associated with facet and ligamentum flavum hypertrophy and partial effacement of the fat at the lateral recesses. There is partial effacement of the fat surrounding the exiting nerve roots with mild encroachment of the exiting nerve roots. There is facet and ligamentum flavum hypertrophy present bilaterally. Overall there is mild to moderate spinal stenosis at this level.At L4-5 there is a diffuse disk bulge present associated with facet and ligamentum flavum hypertrophy and effacement of the fat at the lateral recesses. There is effacement of the fat surrounding the left exiting nerve roots with encroachment of the left exiting nerve roots. Overall there is moderate spinal stenosis at this level.At L3-4 there is a diffuse disk bulge present associated with facet and ligamentum flavum hypertrophy and effacement of the fat at the lateral recesses. There is partial effacement of the fat surrounding the exiting nerve roots with mild encroachment of the exiting nerve roots. Overall there is mild spinal stenosis at this level.At L2-3 there is a diffuse disk bulge present associated with facet and ligamentum flavum hypertrophy and partial effacement of the fat at the lateral recesses. There is partial effacement of the fat surrounding the exiting nerve roots with mild encroachment of the exiting nerve roots. Overall there is mild spinal stenosis at this level.At L1-2 there is a diffuse disk bulge present associated with facet and ligamentum flavum hypertrophy and partial effacement of the fat at the lateral recesses. There is partial effacement of the fat surrounding the exiting nerve roots with mild encroachment of the exiting nerve roots. There is a Schmorl's node at this level with adjacent inflammatory changes.There are cysts present along the kidneys bilaterally measuring up to 12mm diameter.
1.There is a large disk extrusion present at T12-L1 which compresses the conus medullaris. The disk itself appears to have a more cystic appearing component behind the T12 vertebra. There are adjacent inflammatory changes. There is associated encroachment of the right-sided exiting nerve roots within the neural foramen at this level. 2.There are degenerative changes present in the lumbar spine with a moderate to severe degree of spinal stenosis at L4-5 and milder degrees of spinal stenosis at L3-4 and L5-S1.3.There is encroachment of exiting nerve roots within the neural foramina at multiple levels which are appear worse on the left side at L4-5. 4.Findings were discussed with Dr Adam Cifu at the time of this dictation.