History of left leg extremity numbness and weakness, evaluate structural lesion, nerve root impingement, disc herniation. Five lumbar type vertebral bodies are presumed to be present. There is mild decrease in height of L5 vertebral body likely of chronic etiology. Rest of the vertebral body heights are within normal limits. Bone marrow signal is benign. There is slight straightening of the normal lumbar lordosis. The conus medullaris is normal in position. There is increased T2 signal within the visualized distal cord along the upper T12 level, although axial images are not available through this level. There is thin linear intrinsic T1 signal at the lower L1 level within the dorsal thecal sac consistent with a fatty filum. There is mild narrowing of L1-L2, L2-L3, and L5-S1 discs with associated mild desiccation. Mild developmental distal narrowing of the lumbosacral spine is noted secondary to shortened pedicles.Multilevel degenerative changes are seen, as described below:T12-L1: On sagittal imaging there is disc bulging seen causing moderate central stenosis.L1-L2: There is ligamentum flavum thickening. No spinal canal or neural foraminal stenosis.L2-L3: There is disc bulge with bilateral foraminal prominence. There is mild to moderate bilateral foraminal stenosis. There is ligamentum flavum thickening and mild facet hypertrophy. There is effusion within the bilateral facet joints. There is mild spinal canal stenosis.L3-L4: There is disc bulge with moderate to severe bilateral foraminal narrowing right more than the left. There is no central canal stenosis.L4-L5: There is broad-based disc bulge causing right foraminal prominence. There is moderate right foraminal stenosis and mild to moderate left foraminal stenosis. There is evidence of central annular fissure. There is ligamentum flavum thickening and facet hypertrophy. There is facet effusion. There is moderate spinal canal stenosis at this level.L5-S1: There is evidence of vacuum disc component with broad-based disc bulge causing moderate to severe bilateral foraminal narrowing. There is mild ligamentum flavum thickening and facet hypertrophy with small amount of fluid is seen in the facet joints. There is moderate spinal canal stenosis is seen at this level.Paraspinous soft tissues are within normal limits.
1. Moderate multilevel degenerative disease mostly affecting L5-S1 causing moderate to severe bilateral foraminal narrowing.2. Moderate spinal canal stenosis at L4-L5 and L5-S1 associated with mild developmental canal l narrowing.3. Abnormal area of increased T2 signal visualized within the distal cord on sagittal imaging at upper T12 vertebral level. Recommend dedicated MRI of the thoracic spine for further evaluation of this finding.4. Linear increased T1 hyperintensity at the lower L1 vertebral level within the dorsal thecal sac most likely representing incidental fatty hilum. However, this can be associated with tethered cord, and clinical correlation is recommended.5. Decreased body height of L5 vertebra most likely chronic in nature.