MRI: Mild disc degenerative changes are noted from L2 through S1. A Mildly bulging disc occurs at L2-3 with no spinal stenosis. The L3-4 level demonstrates a mildy bulging disc with a small central disc herniation which mildly focally effaces the thecal sac and overall there is moderate central stenosis at this level. A slight retrolisthesis of L3 on 4 is also evident due to mild disc space narrowing. The L4-5 level demonstrates a slightly bulging disc. There is a somewhat asymmetric bulge laterally to the right with no focal erve impingement. The L5-S1 level demonstrates a mildly bulging disc with no disc herniations. The facet joints aremldly degenerated.
Impression 1: Mild disc degererative changes from L2 through S1. 2: Small central disc herniation at L3_4 with moderate central stenosis.
Myleogram:Five non rib bearing lumbar type vertebral bodies are present. There is no evidence for acute fracture or compression deformity. Grade I retrolisthesis is present at multiple levels including L2 through L5. These measure between 3 and 4 mmat the L2-L3,L3-L4 levels. This is most pronounced at the L5-S1 level measuring approximately 6 mm. L1-L2 the intervertabral disc height is well maintained. There is no evidence for signoficant disc bulge, neural foraminal narrowing or central canal stenosis.
L2-L3:There is some mild narrowing of the intervertabral disc space. Mild end plate sclerosis and spuring most notably anteriorly. A mild broad based disc bulge is present which results in some mild flattening of the anterior aspect of the thecal sac.No significant neural foraminal narrowing or nerve root impingement is identified.
L3-L4:There is some mild narrowing of the interertabral disc space. Mild end plate degenerative changes are present as evidenced by sclerosis and mild spurring most anteriorly. A moderate sized broad based disc bulge is present. This results in some thickening of the soft tissues just posterior to the inferior aspect of the L3 vinterverterbral body. This could reflect superior migration of aan extruded disc herniation. This is not definitave and correlation with the patient's MRI is recommended. No significant neural foraminal narrowing or nerve root iimpingement is identified.
L4-L5:The invertabral disc space height is well maintained. A moderate sized broad based disc bulge is present. This is ssomewhat eccentric to the right neural foramen which appears mildly narrowed. No definitive nerve root impingement is identified.
L5-S1 There is narrowing of the intervrtabral disc space. Vacum disc phenomenon is noted. End plate degenerative changes are present as evidenced by sclerosis and spurring. A mild broad based disc bulge is present, This results in mild to moderate bilateral neural foraminal narrowing. No definitive nerve root impingement is identified. No central canal stenosis.
1: Suggestion of a superiorly migrated central disc extrusion at the L3-L4 level.This should be correlated with the patients MRI.
2: Mild to moderate broad based disc bulges at multiple levels as described above. This does result in neural foraminal narrowing most pronounced at L4-L5 on the right and L5-S1 bilaterally. No definite verve root compromise is identified.
3: Mild to moderate central canal stenosis at L3-L4.