Lower lunbar back pain radiating to left. Known radiculopathy.
Findings :
The vertebral body heights are preserved. There is minor straightening of the lunbar spine curvature .
The conus terminates at Ll—2 level.
LI/2 : No significant central canal or exit foraminal narrowing.
L2/3 : No significant central canal or exit foraminal narrowing. Normal facet joints .
L3/4 :Mild diffuse disc bulge causing mild indentation of the thecal sac. No significant exit foraminal narrowing. Normal facet joints.
L4/5:There is disc protrusion into the left lateral recess which measures 23 x 8
(Trans x AP) . There is severe left lateral recess and subarticular narrowing . The transiting left L5 and SI nerve roots appear impinged. The right transiting L5-S1 nerve roots are contacted by this disc protrusion. Bilateral exit foramina are clear and exiting L4 nerve roots are not impinged. Mild bilateral facet joint arthropathy.
L5/S1 :Mild diffuse disc bulge causing mild indentation of the thecal sac. There is disc bulge into the right far lateral recess and ridge contacts the right L5 nerve. Mild narrowing of the left and moderate narrowing of the right exit foramina. Mild right facet joint arthropathy.
CONCLUSION :
L4—5 disc protrusion into the left lateral recess causing impingement of the transiting left L5 and Sl nerve roots and contacting right L5 and Sl nerve root. No impingement of the exiting L4 nerve roots .
L5—S1 disc bulge with right far lateral disc component contacting the right L5 nerve. Moderate right and mild left L5—S1 exit foraminal narrowing.
