L4-L5 Intervertebral Dichotomy

DOI: 3/1/2016. Patient is a 55-year-old female service center manager who sustained a work-related injury to her left arm, left shoulder and lower back when a cooler handle broke and struck her body. As per OMNI entry, patient was diagnosed with lumbar disc disease; cervical disc disease; de Quervain’s stenosing tenosynovitis; and bilateral carpal tunnel syndrome.

MRI of the lumbar spine done on 4/21/16 revealed pathologic L4-L5 intervertebral disc with internal derangement as demonstrated by desiccation and an abnormal posterior prominence of the disc at and distal to the level of the right L4-L5 neural foramina; prominent bulging versus protrusion of the L3-L4 intervertebral disc toward the left side; lumbar facet arthrosis, most pronounced at the L4-L5 level with lateral recess stenosis compromising the cross-sectional diameter of the spinal canal and right/left L4-L5 lateral recesses; and straightening of the lumbar lordosis, which may have a component of muscle spasm. …show more content…
There was no evidence of lumbar radiculopathy.
Per the medical report dated 9/15/16, the patient had bilateral L3, L4, and L5 medial branch blocks on 7/19/2016 that provided 80% decrease in back pain for several hours. Patient was recommended with bilateral L3, L4 and L5 radiofrequency