Fig. 2.

An 84-year-old male with low back pain and right L4 radicular symptoms to the ankle worsened with walking with symptomatic improvement with a right L4-5 transforaminal epidural steroid injection. (a) Right sagittal view of a T2-weighted MRI of the lumbar spine. Note the multilevel degenerative changes and the foraminal stenosis at L4-5 related to disc bulge and facet hypertrophy. (b) Axial view of a T2-weighted MRI through L4-5. Note severe central stenosis on imaging, though symptomatically, he described right L4 radicular symptoms and thus a transforaminal route was chosen