Numbness, pain, burning, fasciculations in the lower extremities. Evaluate for infiltrating pachymeningitis. Five lumbar type vertebral bodies are presumed to be present. Again seen is levoscoliosis of the lumbar spine with apex at the L2-L3 level. Vertebral body heights are within normal limits. Bone marrow signal is benign with T1 hyperintense focus at the T11 vertebral body compatible with focal fat or hemangioma. The conus medullaris is normal in position.Minimal degenerative changes are seen, as described below:L1-L2: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L2-L3: There is a disc bulge without significant spinal canal or neural foraminal stenosis. Facet arthropathy on the right.L3-L4: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L4-L5: Minimal disc bulge. No spinal canal or neural foraminal stenosis. Mild facet arthropathy and ligamentum flavum thickening.L5-S1: Minimal disc bulge eccentric to the left with mild left neural foraminal stenosis. No spinal canal or right neural foraminal stenosis. There is facet arthropathy particularly on the left and ligamentum flavum thickening.Cauda equina nerve roots in the upper lumbar spine are rightward deviated due to the levoscoliosis. No abnormal enhancement is seen involving the cauda equina nerve roots or the epidural space. Paraspinous soft tissues are within normal limits.
1. No abnormal mass or enhancement to suggest pachymeningitis as questioned.2. Moderate levoscoliosis of the lumbar spine with apex at the L2-L3 level as seen previously.3. Mild degenerative changes with mild left L5-S1 neural foraminal narrowing. No significant spinal canal or foraminal stenosis in the remainder of the lumbar spine.