• Satisfactory alignment and segmentation with no transitional vertebrae noted. There is disc dehydration at L4/L5 and L5/S1. No significant end-plate or facet joint degenerative changes are seen throughout. Vertebral body marrow signal is preserved.
• At L3/L4-There is a generalised left lateral disc bulge causing moderate left lateral recess narrowing but no central or foraminal nerve compression.
• At L4/L5- There is a large postero central disc herniation with slight caudal extrusion. This is compressing and effacing the L5 lateral recess nerve roots bilaterally as well as the anterior thecal sac. The anterior CSF space is completely effaced with compression of the anterior cauda equina nerve roots. The extrusion measures 7mm on axial sequences. The changes are resulting in mild central canal stenosis. The cord here however returns normal signal. No foraminal nerve compression is present.
• At L5/S1-There is a generalised disc bulge with a focal left paracentral component. This is abutting but not compressing the left lateral recess S1 nerve root. Appearances are very similar to the previous study.
• Tiny foci of high signal is seen in the coccyx, C2 segment. Although indeterminate and of no clinical significance this likely represents a tiny enchondroma or notochordal remnant.
• Conclusion: Large L4/L5 postero-central disc extrusion compressing and effacing the L5 nerve roots in the lateral recesses bilaterally. The anterior CSF space is completely effaced with compression of the anterior aspect of the cauda equina nerve roots. Focal left paracentral L5/S1 disc bulge abutting the left S1 lateral recess nerve root. Although no frank nerve compression is seen, there maybe slight irritation of the traversing nerve.