69-year-old female with radicular pain. Evaluate for lumbar spinal stenosis in patient with bilateral lower extremity radiculopathy (right greater than left). 5 lumbar vertebral bodies are present. There is grade 1 anterolisthesis of L4 on L5. Multilevel degenerative changes as described below:At L5-S1 loss of disc space height, disc desiccation, diffuse disc bulge with chronic endplate reactive changes as well as facet and ligamentum flavum hypertrophy. There is moderate encroachment of the neural foramen on the right and mild encroachment encroachment of the neural foramen on the left. At L4-5 there is mild anterior subluxation of L4 on L5 associated with uncovering of the disc. There is loss of disc space height and disc desiccation present. There is moderate bilateral facet and ligamentum flavum hypertrophy. There is effacement of the fat at the lateral recesses. There is a effacement of the spinal fluid surrounding the nerve roots within the thecal sac. There is a moderate to severe degree of spinal stenosis.At L3-4 there is loss of disc space height, disc desiccation, diffuse disc bulge, mild facet hypertrophy and moderate ligamentum flavum hypertrophy. There is effacement of the CSF surrounding the nerve roots within thecal sac bilaterally. There is mild narrowing of the neural foramina bilaterally. There is moderate degree spinal stenosis.At L2-3 there is loss of disc space height, disc desiccation, diffuse disc bulge with associated endplate reactive changes including increased signal T1 without increased signal on the STIR sequence compatible with chronic changes. There is mild facet hypertrophy and ligamentum flavum hypertrophy. There is mild effacement of the spinal fluid surrounding the nerve roots within the thecal sac bilaterally. Overall there is a mild degree of spinal stenosis. At L1-2 there is diffuse disc bulge with no significant spinal canal stenosis or neuroforaminal narrowing.At T12-L1 there is diffuse disc bulge with no significant spinal canal stenosis or neuroforaminal narrowing.At T11-T12 there is diffuse disc bulge with no significant spinal canal stenosis or neuroforaminal narrowing.
1.There are multilevel degenerative changes present in the lumbar spine which are worse at L4-5 where there is mild subluxation associated with moderate to severe spinal stenosis.2.There is also moderate encroachment of the nerve roots within the right neural foramen at L5-S1 due to a lateral disc protrusion. 3.There is a moderate degree of spinal stenosis at L3-4. 