NOV-B4-2015 11:56 71 BERNARDRAWL INSMD 1 BERNARD A. RAWLINS, MD HOSPITAL FOR SPECIAL SURGERY ADULT AND PEDIATRIC SPINE SURGERY FACSIMILE TRANSMITTAL SHEET TO: LESLEY GROTT FROM: BRIANNA COMPANY: DATT: NOVEMBER 5, 2015 FAX NUMBIER: ‘TOTAL NO. OF PAGES INCLUDING COVER: (646) 3504396 5 PHONE NUMBER: SENDER’S REFERENCE NUMBER: YOUR REFLREENCE. NUMBER: URGENT XFORREVInW OPLEASE COMMENT OPLEASE REPLY OPLRASH RECYCLE NOTES/COMMENTS: Requested MRI results for Mr. Epstein. Thank you, Brianna 523 LAST 728° STRELYT (282 VLOOR) NEW YORK, NY 10021 TEL: 212 606 1632 FAX 212 6066 1726 EFTA00282969

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: ue rec! P.@2 NOV-@4-2815 11:56 _RIBERNARDRANILINSMD tyasoyens alae COL UeNTLaL And tor Lhe fole use of the intended rac. ; Patient Name Location < HOSPITAL FOR EPSTEIN, JEFFERY Dis ik} SPECIAL SURGERY Ordering Phyeician RAWLINS, BERNARD A 535 East 70th Street Adm/Reg Physician New York, N.Y. 10021 Consulting Physician DEPARTMENT RAWLINS, BERNARD A OP Medical Record # Date of Birth Age RADIOLOGY 840411 01/20/53 62Y AND a IMAGING Check-in Date: 11/03/15 1514 Chk-in # Order Exam 4121712 0001 0533 MRI LUMBAR SPINE Ord Diag: M48,06-SPINAL STENOSIS, LUMBAR Page :1 MRI lumbar spine: Spin-echo sagittal, axial and coronal sequences were obtained and a STIR sagittal sequence. Patient history: Leg weaknese and numb sensation in the lege. The lower thoracic spinal cord and conus medullaris are normal . T12-L1: There is no stenosis. L1l-2: Disc degeneration is identified, There is moderate right and mild left facet arthrosie and no stenosis. L2-3: Disc degeneration is present and a minimal retrolisthesis. There is mild/moderate right and mild left facet arthrosis along with mild thickening of the ligamenta flava. Mild/moderate central canal stenosis is identified and the stenosis is partially on a developmental basis. There is mild left and mild/moderate right neural foraminal stenosis. A emall/moderate eized disc protrusion projects into and slightly lateral to the right neural foramen and causes minimal impingement of the right L2 nerve root immediately lateral to the neural foramen, L3-4: Disc degeneration is present. Mcderate/severe right and moderate left facet arthrosis is associated with thickening of the ligamenta flava. Moderate central canal stenosis is identified and the stenosis is partially on a development basis. There is mild/moderate left neural foraminal stenosis and a small/moderate sized disc protrusion projects into and slightly lateral to the neural foramen and causee mild Page :1 , Report Continued on Next Page RAWLINS ,BERNARD A FINAL FINAL HSS-523 EAST 72ND sT 2TH FL--SOUTH NEW YORK NY 10021 ~262; ;262;0533;4121712-0533- EFTA00282970

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NOU-@4-, : 71BERNARDRAWLINSMD 2126061726 P.@3 64-2015 11:56 ce meas ee _2IBERN au tani Lea 15 PCLVILEgCR ait Confidential and tor the sole use of the intended ree. WA HOSPITAL FOR oy — Location By SPECIAL SURGERY Ordering Physician RAWLINS, BERNARD A 535 East 70th Street Adm/Reg Physician New York, N.Y. 10021 Consulting Physician DEPARTMENT RAWLINS , BERNARD A OF Medical Record # Date of Birth Age RADIOLOGY 640411 01/20/53 62Y AND 9 IMAGING Check-in Date: 11/03/15 1514 Checkin-Exam Code Summary 4121712-0533 (Continued) Page 2 impingement of the left L3 nerve root at the exit zone and slightly lateral to the neural foramen, There ig mild/moderate right neural foraminal stenosis and a small/moderate sized disc protrusion projects into and slightly lateral to the right neural foramen and causes minimal impingement of the right L3 nerve root at the exit zone of the neural foramen. L4-5: Disc degeneration is present and mild posterior bulge of the disc. There ie a prominent fissure in the outer annulue adjacent to the left neural foramen. Severe facet arthroeis is aesociated with an approximate 2 mm anterolisthesis. There is thickening of the ligamenta flava and severe stenosis of the central canal and the subarticular recesses. The stenosis is partially on a developmental baeis. There is a small collection of fluid located subjacent to the left ligamentum flavum, medial to the left facet joint. and possibly a very small collection of fluid in the right ligamentum flavum. The LS nerve roote exit the thecal sac approximately 7 mm caudad to the diac space. Severe left neural foraminal stenosis causes impingement of the left La nerve root. There is moderate right neural foraminal etenosis and a emall/moderate sized disc protrusion projecte into the neural foramen and impinges the right L4 nerve root. LS-S1: Disc degeneration is present. Severe right and mild left facet arthrosis is detected and mild/moderate central canal stenosis, that is partially on a developmental basis. There is compression of the $1 nerve roots, more prominent on the right, between the facete and the disc, depicted in axial images 13-14 in series 6. Mild left and moderate right neural foraminal stenosis is detected. Page :2 , Report Continued on Next Page RAWLINS, BERNARD A FINAL FINAL HSS-523 EAST 72ND ST 2TH FL--SOUTH NEW YORK NY 10021 ~262; ;262;0533;4121712-0533~ EFTA00282971

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NOU-B4-2015 11:57 71 BERNARDRAWL INSMD HI P.a4 a4 LM bMko 4UA 2D PLAVLIege ANG cuntidentaal and f. “Ne SOLé une of the intended roc Pa HOSPITAL FOR or Location SS SPECIAL SURGERY ing’ Physiei prs Ordering Physician RAWLINS, BERNARD A 535 East 70th Street Adm/Reg Physician New York, N.Y, 10021 Consulting Physician DEPARTMENT RAWLINS, BERNARD A or . Medical Record # Date of Birth Age RADIOLOGY 840411 01/20/53 62Y AND 9. IMAGING Check-in Date: 11/03/15 1514 Checkin-Exam Code Summary 4121712-0533 (Continued) Page 3 There is partial ankylosis of the anterosuperior compartment of the SI joints. Impression: 1. Ll-2: Dise degeneration. Facet arthrosis. 2. L2-3: Disc degeneration. Mild/moderate central canal stenosis. Small/moderate sized diec protrusion projects into and slightly lateral to the right neural foramen and causes minimal impingement of the right L2 nerve root immediately lateral to the neural foramen. 3. L3-4: Disc degeneration. Facet arthrosis. Moderate central canal stenosis. Small/moderate sized disc protrusion projects into and slightly lateral to the left neural foramen and causes mild impingement of the {ett L3 nerve root at the exit zone and slightly lateral to the neural foramen. Small/moderate sized disc protrusion projects into and slightly lateral to the right neural foramen and causes minimal impingement of the right L3 nerve root at the exit zone of the neural oramen. 4. L4-5:; Disc degeneration. Grade 1 degenerative anterolisthesigs. Severe stenosis of the central canal and the subarticular recesses. Severe left neural foraminal stenosis causes impingement of the left L4 nerve root. Moderate right neural foraminal stenosis and a small/moderate sized diac protrusion projects into the neural foramen and impinges the right L4 nerve root. 5. L5-S1: Disc degeneration. Facet arthrosis, more prominent on the Page :3 , Report Continued on Next Page RAWLINS, BERNARD A FINAL FINAL HSS-523 EAST 72ND ST 2TH FL--SOUTH NEW YORK NY 10021 ~262; ; 262; 0533 ;4121712-0533~ EFTA00282972

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— : RAWLINSMD nt hl” NOV-B4—2815 Al 3? - aw _ LI BERNARDRAM ate Ae PU AVAL CYOM GHA LUILLLUCIL IAL and ro ne cole use of the inlended rec ; Patient Name Location 4 HOSPITAL FOR EPSTEIN, JEFFERY DIS [ky SPECIAL SURGERY Ordering Physician RAWLINS, BERNARD A 535 East 70th Street Adm/Reg Physician New York, N.Y. 10021 Consulting Physician DEPARTMENT RAWLINS, BERNARD A Or Medical Record # Date of Birth Age RADIOLOGY 840411 01/20/53 62¥ AND 9 IMAGING Check-in Date: 11/03/15 1514 Checkin-Exam Code Summary 4121712-0533 (Continued) Page 4 right. Compression of the S1 nerve roots, more prominent on the right, between the facets and the disc. Mild/moderate central canal stenosis. 6. The results of the MRI exam were reported to Dr. Rawlins on 11/4/2015. Ordering Diagnosis ICD 10: M48.06: SPINAL STENOSIS, LUMBAR REGION Dictated By- RICHARD HERZOG M.D. Personally Viewed- RICHARD HERZOG M.D. Agreed with- RICHARD HERZOG M.D. Released Date Time- 11/05/15 0748 Page :4 , End of Report RAWLINS, BERNARD A FINAL PINAL HSS-523 EAST 72ND ST 2TH FL--SOUTH NEW YORK NY 10021 ~262; ;262;0533;4121712-0533~ TOTAL P.@S EFTA00282973