77-year-old female with sciatica not improving. There is slight straightening of the normal lumbar lordosis. The vertebral body heights are preserved. There is mild narrowing of the disks involving the lower lumbar levels. The vertebral bone marrow signal is unremarkable. The spinal cord displays normal signal and morphology and terminates at the L1-L2 level. Degenerative changes are seen in the lumbar spine as described below:T12-L1: There is a shallow central disc protrusion but no significant compromise to spinal canal or neural foramina.L1-L2: There is a minimal disc bulge, mild facet hypertrophy and ligamentum flavum thickening but no significant compromise to spinal canal or neural foramina.L2-L3: There is a right paracentral to foraminal disc protrusion and a left foraminal disc protrusion which along with mild facet hypertrophy and ligamentum flavum thickening causes mild bilateral neural foraminal stenosis. No significant compromise to spinal canal is visualized.L3-L4: There is a trace disc bulge with left greater than right foraminal prominence as well as mild to moderate facet hypertrophy and ligamentum flavum thickening which causes minimal to mild right and moderate to severe left neuroforaminal stenosis. No significant compromise to spinal canal is visualized.L4-L5: There is a mild to moderate disc bulge with right foraminal prominence as well as moderate facet hypertrophy and ligamentum flavum thickening which causes moderate to severe right and moderate left neural foraminal stenosis. The right foraminal disc may abut the right L4 exiting nerve root. No significant compromise to spinal canal is visualized.L5-S1: There is a mild disc bulge and a large right far lateral disc osteophyte as well as mild facet hypertrophy and ligamentum flavum thickening which causes mild right neural foraminal stenosis but no left foraminal or central canal stenosis. The paravertebral soft tissues are unremarkable. Bilateral small T2 hyperintense lesions within the kidneys are nonspecific, but statistically most likely represent benign renal cysts.
Overall mild to moderate spondylotic changes involving the lower lumbar spine without significant central canal stenosis but with up to moderate to severe neuroforaminal stenosis at the left L3-4 and right L4-5 levels.