Male, 39 years old, with history of ALL and new bilateral testicular lesions concerning for leukemic involvement. Patient with worsening sciatica for one week, left more than right. Thoracic:No pathologic medullary or leptomeningeal enhancement is seen. No intraspinal masses are detected. Cord signal characteristics and morphology are normal.Spinal alignment is anatomic. Vertebral body morphology is normal. Marrow signal characteristics are slightly heterogeneous but without concerning marrow replacement or pathologic enhancement.A very small central disk protrusion is seen at T10-11. No significant spinal canal stenosis or neuroforaminal narrowing is detected at any level. Scattered small Schmorl's nodes are seen at lower thoracic levels.Lumbar:The distal spinal cord, conus and nerve roots of the cauda equina show normal morphology and signal characteristics. No pathologic enhancement is suspected. No intraspinal masses are seen.Spinal alignment is anatomic. Vertebral body morphology is unremarkable allowing for scattered small Schmorl's nodes. Again, marrow signal is slightly heterogeneous but without concerning areas of marrow replacement or pathologic marrow enhancement.T12-L1: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis.L1-2: Mild facet hypertrophy. Mild loss of disk height and T2 signal. No significant spinal canal or neuroforaminal stenosis. L2-3: Mild facet hypertrophy. Loss of disk T2 signal. No significant spinal canal or neuroforaminal stenosis. L3-4: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. L4-5: Moderate facet hypertrophy. No significant spinal canal stenosis. Minimal bilateral foraminal narrowing. L5-S1: Moderate facet hypertrophy. Large left subarticular/foraminal disk protrusion with impingement of the transiting left S1 nerve root. Mild effacement of the left ventral spinal canal. Moderate left foraminal narrowing. Mild right foraminal narrowing.
1. Large left-sided disk protrusion at L5-S1 with impingement of the transiting left S1 nerve root2. Very mild degenerative findings at additional levels.3. No evidence to suggest neoplastic involvement in the spinal canal or bony elements.