73-year-old male with back pain that is better with getting up and walking. Alignment is anatomic. Vertebral body heights are within normal limits. Scattered areas of T1 hyperintensity in the vertebral bodies likely represent focal fat or hemangiomas. The conus medullaris is normal in position. Left renal cysts are also noted. The paraspinous soft tissues are otherwise within normal limits. Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No significant spinal canal or neural foraminal stenosis. L2-L3: Mild facet arthropathy. Reduced T2 signal of the disc without loss of disc height or disc bulge. No significant spinal canal or neural foraminal stenosis.L3-L4: Moderate facet arthropathy. Reduced T2 signal of the disc with mild loss of disc height. In addition to a mild, predominantly lateral disc bulge, this results in mild bilateral neural foraminal stenosis. No significant spinal canal stenosis.L4-L5: Moderate facet arthropathy and ligamentum flavum thickening. Reduced T2 signal of the disc without significant loss of disc height. In addition to a mild disc bulge, this results in moderate left and mild right neural foraminal stenosis. The left lateral recess is effaced, greater than the right, with crowding of the descending L5 nerve roots. No significant spinal canal stenosis.L5-S1: Moderate facet arthropathy. Reduced T2 signal of the disc without significant loss of disc height. In addition to a mild disc bulge, this results in mild bilateral neural foraminal stenosis. No significant spinal canal stenosis. Right subarticular annular fissure is also noted.
Relatively mild degenerative changes of the lumbar spine without high-grade spinal canal or neural foraminal stenosis. At worst, there is moderate left neural foraminal stenosis at the L4-5 level.