Bilateral L4, L5 radiculopathy. Evaluate for nerve root impingement. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild loss of lumbar lordosis. Alignment is otherwise maintained. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. Multilevel degenerative changes are seen with disc desiccation and height loss at multiple levels, relatively worst at the L4-L5 level and T12-L1 levels, where there is at least moderate degree of disc height loss with suggestion of vacuum phenomena. Fatty endplate marrow changes at L4-L5. Multilevel degenerative changes are seen, as described below:T12-L1: Mild disc bulge without significant spinal canal or neural foraminal stenosis.L1-L2: Mild disc bulge. Mild effacement of the lateral recesses. No central spinal canal or neural foraminal stenosis.L2-L3: There is disc bulge, ligamentum flavum thickening, prominence of the dorsal epidural fat, and mild facet arthropathy. There is resulting mild spinal canal stenosis. No significant neural foraminal stenosis.L3-L4: Mild disc bulge with partial effacement of the lateral recesses. No significant central canal stenosis. Minimal narrowing of the neural foramina. Mild to moderate bilateral facet arthropathy.L4-L5: Disc bulge, ligamentum flavum thickening, and moderate bilateral facet arthropathy. There is no significant central canal stenosis. There is moderate right and moderate to severe left neural foraminal stenosis, where there may be impingement of the exiting L4 nerve roots. There is also effacement of the lateral recesses which may be affecting the descending L5 nerve roots.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild to moderate bilateral facet arthropathy.
1. Multilevel degenerative changes in the lumbar spine, relatively worse at the L4-L5 level where there is moderate right and moderate to severe left neural foraminal stenosis. There is also effacement of the lateral recesses. There may be impingement of the L4 and L5 nerve roots at this level as described above.2. No high-grade spinal canal stenosis at any level. Central spinal canal stenosis is relatively worse at L2-L3, and is mild in degree.