68-year-old female with sciatica. Acute left L5 -- S1 pain status post lifting. The density of vertebral column is within normal limits. There is grade 1 anterolisthesis of L5 in respect to S1. No evidence of pars defect is detected.T12 -- L1.Examined this level is unremarkable.L1 -- L2. Moderate degenerative degenerative disk disease with broad-based bulge of disk material is noted. No neuroforamina compromise or central spinal stenosis.L2 -- L3.Degenerative disk disease with very broad based bulge of disk material at this level is present this is more pronounced on the right side and I cannot entirely rule out possibility of a herniated disk. No should be made that CT is not sensitive for the definitive detection of herniated disk. An MRI is recommended. There is compromise of the right neuroforamina and to a lesser degree left neuroforamina. No central spinal stenosis.L3 -- L4.Mild degenerative disk disease and hypertrophy changes of posterior elements are present. No definitive central spinal stenosis or neural foramina compromise.L4 -- L5. Moderate to advanced degenerative disk disease is present. Diffuse bulge of disk material causes flattening and posteriorly displaces the thecal sac. No definitive evidence of neural foramina compromise is identified. There is however bulge of the hypertrophied ligamentum flavum into the neuroforamina posteriorly. There is also compromise of the lateral recesses of the canal at this level secondary to combination of hypertrophic changes of posterior elements and bulging disk. No definitive central spinal stenosis.L5 -- S1.Advanced degenerative disk disease with significant vacuum phenomenon is noted. There is grade 1 anterolisthesis at this level. There is compromise of bilateral neural foramina are in an. There is diffuse pseudo-bulge of disk material. On this examination I cannot entirely rule out possibility of a herniated disk.
Extensive degenerative changes of disk and posterior elements as detailed above. 