70 years Female (DOB:11/6/1946)Reason: pain History: painPROVIDER/ATTENDING NAME: RODERICK H. BIRNIE RODERICK H. BIRNIE Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is disc desiccation present at this level associated with a diffuse disc bulge marked bilateral facet and ligamentum flavum hypertrophy there is associated narrowing of the neural foramina. Although the neural foraminal are narrowed, within the neural foramina the exiting nerve roots are surrounded by fat. There are some partial effacement of the fat at the lateral recess bilaterally resulting in encroachment of the nerve roots at the lateral recess bilaterally.At L4-5 there is loss of disc space height, disc desiccation and diffuse disc bulge associated marked bilateral facet and ligamentum flavum hypertrophy. There is mild anterior subluxation of L4-5. There is crowding of the nerve roots within the thecal sac. There is narrowing of the neural foramina bilaterally with encroachment of the nerve roots within the neural foramina bilaterally worse on the left side compared to the rightAt L3-4 there is no significant compromise to spinal canal or neural foramina. There is a mild to moderate degree of facet and ligamentum flavum hypertrophy at this level. There is a mild disc bulge at this level.At L2-3 there is no significant compromise to spinal canal. There is mild facet and ligamentum flavum hypertrophy at this level there is a right far lateral disc protrusion at this level encroaching right-sided exiting nerve root within the neural foramen. There are Schmorl's nodes at this levelAt L1-2 there is no significant compromise to spinal canal or neural foramina. There is a disc bulge at this level.
1.There are multilevel degenerative changes present in the lumbar spine worse at L4-5 where there is moderate degree of spinal stenosis associated with encroachment of the exiting nerve roots within the neural foramina predominantly on the left side.2.There is encroachment of nerve roots at the lateral recess bilaterally at L5-S1 related to degenerative change3.There is a right far lateral disc protrusion present at L2-3 which encroaches the right-sided exiting nerve root