Clinical question: Evaluate for disk herniation/cord compression. Signs and symptoms: Tearing sensation with left-sided radiculopathy. Unable to move 2/2 pain Pre-and post-enhanced lumbar MRI:T12 -- L1 demonstrate no spinal stenosis or neural foramina compromise.Examination demonstrates mild compression fracture of L1 vertebral body with extensive increased marrow signal intensity suggestive edema. Finding is suggestive of a recent fracture. The longest cranial cephalad axis of L1 vertebrae measures at 24.7-mm compared to 18-mm at the level of maximum compression. Very subtle expansion of fractured vertebrae into the spinal canal without central spinal stenosis. There is however mild to moderate left neural foramina secondary to degenerative changes is present. There is no detectable perispinal soft tissue abnormality. Post-enhanced images demonstrate a patchy band of enhancement surrounding the compressed vertebrae. Follow-up exam is recommended to entirely exclude the remote possibility of a mass.The alignment the vertebral column is anatomical.L2 -- L3 demonstrate minimal degenerative changes and unremarkable otherwise.L3 -- L4 demonstrate mild degenerative disk disease and mild bilateral facet and ligamentum flavum hypertrophy. No spinal stenosis or neural foraminal compromise. Minimal left facet effusion is present.L4 -- L5 demonstrate mild disk desiccation and mild bilateral facet and ligamentum flavum hypertrophy. There is a broad-based central and rightward disk protrusion which results in moderate central spinal stenosis and right neural foraminal compromise. Mild left neural foraminal compromise secondary to degenerative disease is also present.L5 -- S1 demonstrate mild to moderate disk desiccation and loss of disk height, small central and leftward disk protrusion is present. No evidence of central spinal stenosis. A right-sided disk osteophyte complex results in severe right neural foraminal compromise.Post-enhanced images at this level demonstrates subtle enhancement of the adjacent endplates representing Modic changes inno detectable abnormal enhancement of the cord or leptomeninges.
1.Mild likely subacute compression fracture of L1 vertebrae with subtle expansion into the spinal canal without spinal stenosis. Mild to moderate left neural foraminal compromise at L1 -- L2 secondary to degenerative disease is present.2.Degenerative changes at L4 -- L5 and a large broad-based disk protrusion results in central spinal stenosis and neural foraminal compromise as detailed.3.Extensive degenerative changes at L5 -- S1 without central spinal stenosis. Disk osteophyte complex on the right results in significant right neural foraminal compromise. 