77-year-old male with weakness, falls. Evaluate for cord compression. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is multilevel disc desiccation with moderate to severe loss of intervertebral disc space height at the L4-L5 and L5-S1 levels. There is approximately 6 mm, grade 1 of L5 on S1 anterolisthesis. There is additional minimal anterolisthesis of L2 on L3 and L3 on L4, as well as minimal retrolisthesis of L4 on L5. Degenerative bone marrow endplate changes are noted at the L4-L5 and L5-S1 levels. The conus medullaris is normal in position. Paraspinous soft tissues are within normal limits.Multilevel degenerative changes are seen, as described below:T11-T12: Only sagittal images were obtained. Within this limitation, there appears to be moderate right and mild left neural foraminal stenoses.T12-L1: Mild facet arthropathy. No significant disc disease. No spinal canal or neural foraminal stenosis.L1-L2: Mild facet arthropathy and ligamentum flavum thickening. No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge, facet arthropathy and ligamentum flavum thickening causes mild spinal canal stenosis, mild to moderate left and mild right neural foraminal stenoses.L3-L4: Moderate disc bulge, moderate to severe facet arthropathy and ligamentum flavum thickening causes mild to moderate spinal canal stenosis and mild bilateral neural foraminal stenosesL4-L5: Moderate disc bulge eccentric to the left, moderate facet arthropathy and ligamentum flavum thickening causes moderate spinal canal stenosis, moderate to severe left and moderate right neural foraminal stenoses.L5-S1: Moderate disc bulge with right foraminal protrusion and right paracentral annular fissure, as well as severe facet arthropathy, causes moderate to severe spinal canal stenosis, severe right and moderate to severe left neural foraminal stenoses. Of note, there is focal prominence of the ventral epidural fat at the right aspect of the L5 level causing moderate to severe maximal spinal canal stenosis at the mid L5 level.Degenerative changes of the left SI joint are also noted.
1. Multilevel degenerative changes of the lumbar spine, with moderate spinal canal stenosis at the L4-L5 level and moderate to severe spinal canal stenosis extending more inferiorly to the L5-S1 level.2. Multilevel neural foraminal stenosis, worst at the L4-L5 and L5-S1 levels. Additional details as above.