Clinical question:? Disk herniation. Signs and symptoms: Back pain and sciatica. Nonenhanced lumbar MRI:Lower most visualized thoracic spine and thoracic cord is unremarkable.T12 -- L1 is unremarkableL1 -- L2 demonstrate moderate disk disease and loss of disk height and mild degenerative changes of the posterior elements without central spinal stenosis or neural MR compromiseL2 -- L3 demonstrate mild disk disease and loss of disk height and mild bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis or neural foraminal compromiseL3 -- L4 demonstrate moderate disk disease and loss of disk height, moderate ligamentum flavum hypertrophy and mild facet disease. Constellation of changes results in moderate central spinal stenosis and mild right neural foraminal compromise.L4 -- L5 demonstrate advanced disk disease and loss of disk height, mild grade 1 anterolisthesis, moderate bilateral ligamentum flavum hypertrophy (right greater than left), facet disease and with images of widening of the facet spaces demonstrating T2 hyperintensity (facet effusion or inflammatory change). Constellation of changes result in moderate to severe central spinal stenosis and moderate to severe bilateral neural foraminal compromise.L5 -- S1 demonstrate moderate to severe disk degeneration and loss of disk height, moderate symmetrical bilateral ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis however a mild to moderate bilateral neural foraminal compromise is detected.Limited view of the SI joints demonstrate no abnormalities.Perispinal soft tissues and musculature remains unremarkable.
1.Extensive degenerative changes at L4 -- L5 and including mild grade 1 anterolisthesis results in significant central spinal stenosis and moderate to severe neural foraminal compromise.2.Degenerative changes at L3 -- L4 results in moderate central spinal stenosis and mild right neural foraminal compromise.3.Degenerative changes at the L5 -- S1 with resultant mild to moderate bilateral neural foraminal compromise and no central spinal stenosis.4.Mild degenerative changes at other levels however without spinal stenosis or significant neuroforaminal compromise. Please see detailed report per level above.