60 year old male patient with back pain. Evaluate for nerve compression. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. The conus medullaris is normal in position. There is mild prominence of the dorsal epidural fat.There is spondylolysis of L5 with grade 1-2 spondylolisthesis of L5 on S1. There is trace retrolisthesis of L1 on L2 and L2 on L3. There are anterior osteophytes throughout the lumbar spine with disc dessication at all levels, which is most severe at L5/S1. There is mild endplate irregularity of lower lumbar spine with a small focus of enhancement within the superior endplate of L3 which is likely degenerative in etiology. Furthermore, there is enhancement within the epidural space at L5/S1 as well as the facet joints, likely on a degenerative basis. Additional multilevel degenerative changes are as described below:L1-L2: Mild posterior disc bulge without significant spinal canal or neural foraminal stenosis. L2-L3: Minimal posterior disc bulge without significant spinal canal stenosis. Ligamentum flavum thickening and facet hypertrophy contribute to minimal right neural foraminal stenosis.L3-L4: Minimal posterior disc bulge eccentric to the right, ligamentum flavum thickening, and facet hypertrophy without significant spinal canal and minimal right neural foraminal stenosis.L4-L5: Mild posterior disc bulge, ligamentum flavum thickening, and moderate facet hypertrophy contribute to mild spinal canal stenosis, particularly involving the lateral aspect of the thecal sac, moderate to severe left neural foraminal stenosis, and mild to moderate right neural foraminal stenosis. L5-S1: Grade 1-2 spondylolisthesis of L5 on S1 with disc uncovering, ligamentum flavum thickening, and moderate facet arthropathy cause severe left and mild to moderate right neural foraminal stenosis. No significant spinal canal stenosis.Paraspinous soft tissues are within normal limits.
Multilevel degenerative changes of the lumbar spine, worst at the L4-L5 and L5-S1 levels. There is grade 1-2 spondylolisthesis of L5 on S1 with bilateral pars defects of L5. There is significant neural foraminal stenosis at L4-L5 and L5-S1, worse on the left than the right. Please see additional details above.