Clinical question: No back pain with radicular symptoms. Signs and symptoms: As above. Pre and post enhanced lumbar MRI:T12-L1 demonstrate mild degenerative changes and unremarkable otherwise.L1-L2 demonstrate a small left paramedian disc protrusion with minor indentation of thecal sac. No spinal stenosis, or neural foraminal or lateral recess compromise.L2-L3 demonstrate mild to moderate disc disease and loss of disc height, mild bilateral ligamentum flavum hypertrophy, mild facet disease however with evidence of bilateral facet effusion. There is also minimal grade 1 retrolisthesis at this level. No spinal stenosis or neural foraminal compromise.L3-L4 demonstrate mild disc disease and loss of disc height and mild bilateral ligamentum flavum hypertrophy. Mild bilateral facet effusion and mild degenerative changes. There is a linear increased T2/T2 STIR signal intensity on the left and far laterally representing a small annular fissure. There is no evidence of a spinal stenosis, lateral recess or neural foraminal compromise.L4-L5 demonstrate advanced degenerative disc disease and loss of disc height, mild right lateral facet and ligamentum flavum hypertrophy without spinal stenosis or neural foraminal compromise.There is sacralization of S1 and without intravenous of a spinal stenosis or neural foraminal compromise.Post enhanced images demonstrate no detectable enhancement of the cord, cauda equina or the leptomeninges. There is expected subtle enhancement of the above detailed annular fissure and unremarkable post infused images of lumbosacral spine.When compared with prior examination from 2013 there is no significant interval change in the extent of the findings detailed above.
1.Degenerative changes of the lumbar spine however without evidence of spinal stenosis, neural foraminal or lateral recess compromise.2.Tiny right lateral disc protrusion at L1-L2 on the left and an annular fissure on the left at L3-L4 as detailed.3.No abnormal enhancement of the vertebral column, lowermost visualized thoracic cord, conus or the cauda equina.