Clinical question: Left lumbar radiculopathy. Signs and symptoms: Left thigh/buttock pain. Nonenhanced lumbar MRI:Signal intensity of the vertebral column is within normal in all MRI sequences.The lower most visualized thoracic spine and thoracic cord from T10 inferiorly is unremarkable.T12-L1, L1-L2, L2-L3 and L3-L4 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L4-L5 demonstrate mild disc disease and loss of disc height, moderate (right greater than left) facet and ligamentum flavum hypertrophy and trace anterolisthesis at this level. There is a shallow right lateral and far lateral disc protrusion at this level which in combination with degenerative changes results in severe right lateral recess and right neural foraminal compromise. Degenerative changes result in mild central spinal stenosis. L5-S1 demonstrate mild disc disease, severe bilateral facet hypertrophy and without significant ligamentum flavum hypertrophy. There is no spinal stenosis or neural foraminal compromise.There is spinal soft tissues and partially visualized SI joints are unremarkable.
1.At L4-L5 there is degenerative changes as well as a right lateral and far lateral disc protrusion with resultant significant right neural foraminal and lateral recess compromise. Degenerative changes at this level also results in trace anterolisthesis and mild spinal stenosis.2.Mild degenerative changes at other levels however without central spinal or neural foraminal compromise.