Patient with history of stenosis presenting with severe right-sided lumbar radiculopathy. The axial T1-weighted images are degraded by patient motion. There is multilevel degenerative spondylosis. At L1-L2, there is hypertrophy of ligamentum flavum and degenerative facet joint disease without significant spinal canal or neural foraminal stenosis. There is mild loss of intervertebral disc space at this level. At L2-L3, there is mild facet joint degenerative disease without significant spinal canal or neural foraminal stenosis. At L3-L4, there is thickening of the ligamentum flavum, facet joint hypertrophy, and epidural lipomatosis, resulting in severe spinal canal and mild right neural foraminal narrowing. At L4-L5, there is loss of disc height with mild disc bulging, ligamentum flavum thickening, facet joint hypertrophy, and epidural lipomatosis, resulting in moderate to severe central spinal canal stenosis and moderate bilateral neural foraminal narrowing. At L5-S1, there are mild disc herniations, prominent ligamentum flavum thickening, facet joint hypertrophy, and epidural lipomatosis, resulting in moderate right and severe left neural foraminal narrowing. There are endplate degenerative bone marrow signal alterations and scattered areas of fatty marrow at multiple levels of the lumbar spine. The imaged portions of the spinal cord are unremarkable. The lumbar spine alignment is anatomic and the vertebral body heights are preserved. The paraspinal soft tissues are unremarkable. There is nodularity of the left adrenal gland.
1. Multilevel degenerative spondylosis and epidural lipomatosis, with marked narrowing of the spinal canal at L3-4 through L5-S1 and variable degrees of neural foraminal narrowing.2. Nonspecific nodularity of the left adrenal gland, which can be further evaluated via dedicated imaging.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.