Diagnosis: Radiculopathy, lumbar regionClinical question: eval for lumbar disk herniationSigns and Symptoms: lumbar radiculopathy, h/o herniation s/p surgery in 2001 Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is disc desiccation at this level as well as a mild disc bulge. There is effacement of the fat at the lateral recess bilaterally at this level but worse on the right than the left side. There is encroachment of the nerve roots at the lateral recess bilaterally.At L4-5 there is loss of disc space height and a broad-based central disc protrusion associated with some mild triangulation of the thecal sac and partial effacement of fat at the lateral recess bilaterally but worse on the right side. The encroachment of the nerve roots is worse at the right lateral recess versus the left. There is mild ligamentum flavum hypertrophy at this level. Overall there is a mild to moderate degree of spinal stenosis at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There is encroachment of the nerve roots at the lateral recess bilaterally at L5-S1 and on the right at L4-5 due to disk disease as detailed above.