Reason: eval herniation History: left lumbar back pain, with LLE weakness and knee pain Examination is mildly motion degraded. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is mildly heterogeneous without focal suspicious lesions. There is a rounded lesion associated with the inferior L5 endplate on the left with surrounding edema most compatible with Schmorl's node. The conus medullaris is normal in position.Mild degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L4-L5: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L5-S1: There is disc desiccation and bulge with a small central protrusion. There is also ligamentum flavum thickening and mild facet arthropathy. There is partial effacement of the lateral recesses, worse on the left than the right. There is mild left neural foraminal narrowing. No significant right neural foraminal narrowing. Paraspinous soft tissues are within normal limits. Bilateral renal cysts are noted.
1. Mild degenerative changes in the lumbar spine. There is a disc protrusion at the L5-S1 level which may be impinging on the left S1 nerve root in the lateral recess. There is also mild left neural foraminal narrowing at this level. Spinal canal and neural foramina in the lumbar spine are otherwise patent.2. Rounded lesion associated with the inferior L5 endplate with surrounding edema is favored to represent an acute Schmorl's node.