 There is moderate levolumbar scoliosis centered at L2-L3. There is left lateral translation of L3 on L4. The vertebral body heights are grossly preserved. There is severe loss of disc height and endplate degenerative changes at L3-L4 and L4-L5. The vertebral bone marrow signal is mildly heterogeneous with scattered foci of T1 hyperintense signal, likely representing focal fatty replacement or fat-containing hemangiomas. There is a T1 isointense and T2 hyperintense lesion in the T11 vertebral body that measures up to 17 mm. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. Incidentally noted is a 4.5 cm right upper pole renal cyst. The abdominal aorta appears to be mildly ectatic and there is crescentic signal projecting over the lumen.T12-L1: Thickening of the ligamentum flavum. Mild left greater than right foraminal stenosis, but no significant spinal canal stenosis. L1-L2: Disc bulge, thickening of the ligamentum flavum and facet arthropathy, contributing to mild right neural foramen stenosis, but no significant spinal canal stenosis. There is also a sucentimeter posteromedially directed left facet synovial cyst. L2-L3: Disc bulge with superimposed left paracentral and left foraminal disc protrusions, thickening of the ligamentum flavum and facet arthropathy, contributing to moderate to severe right foraminal stenosis, effacement of the right lateral recess with impingement of the nerve roots and mild to moderate spinal canal stenosis. L3-L4: Disc bulge with superimposed central disc protrusion, thickening of the ligamentum flavum and facet arthropathy, contributing to moderate to severe right and minimal left foraminal stenosis and mild to moderate spinal canal stenosis, with impingement of the nerve roots in the left lateral recess. L4-L5: Disc bulge with superimposed central disc protrusion, thickening of the ligamentum flavum and facet arthropathy, contributing to moderate to mild right and severe left foraminal stenosis and effacement of the lateral recesses, with impingement of the nerve roots in the left lateral recess. L5-S1: Disc bulge, thickening of the ligamentum flavum and facet arthropathy, contributing to mild left foraminal stenosis. No significant spinal canal stenosis.
1. Advanced degenerative spondylosis of the lumbar spine with moderate levolumbar scoliosis, most prominent at L2-L3 and L3-L4, with lateral listhesis of L3 on L4 as well as mild to moderate spinal canal stenosis associated with apparent nerve root impingement and variable multilevel foraminal stenosis, as described in the findings section.2. A T1 isointense and T2 hyperintense lesion in the T11 vertebra that measures up to 17 mm may represent an atypical hemangioma or perhaps less likely a neoplastic process. Followup via an MRI with contrast may be useful.3. The abdominal aorta appears to be mildly ectatic and there is crescentic signal projecting over the lumen, which may be artifact rather than intramural thrombus. Nevertheless, a Doppler ultrasound may be useful for further evaluation.Findings were conveyed to Dr. Tung on 3/26/2015 by EPIC mail.