Kyphosis. Assess for spinal canal stenosis. There is straightening of the lumbar spine alignment in the sagittal plane. There are small central indentations along the inferior endplates of L1 and L5, but no significant overall vertebral body height loss. There is degenerative signal alteration subjacent to the endplates at multiple levels. There is also 1 cm diameter lesion involving the right side of the first sacral segment, which may represent a hemangioma. There is generalized lumbar disc T2 signal loss, as well as moderate height loss. There is suggestion of mild Baastrup disease at multiple levels. The tip of the conus medullaris is located at the lower L1 level. The conus displays normal morphology and signal. There is fatty infiltration of the posterior paraspinal muscles due to atrophy. Multiple well-circumscribed, homogeneously T2-hyperintense, T1-hypointense lesions involving the kidneys likely represent cysts, but there are not completely assessed.L1-L2: A disc bulge with a left paracentral broad-based protrusion results in narrowing of the left subarticular recess with posterior displacement of the traversing left L2 nerve roots. Mild facet arthropathy contribute to mild bilateral neural foraminal stenosis.L2-L3: A disc bulge is slightly eccentric to the right resulting in mild stenosis of the right subarticular recess and mild central spinal canal stenosis. Mild facet arthropathy contribute to mild-to-moderate bilateral neural foraminal stenosis. There is also a tiny perineural cyst in the left neural foramen.L3-L4: A disc bulge along with moderate facet arthropathy result in moderate spinal canal stenosis. There is also mild bilateral neural foraminal stenosis.L4-L5: A disc bulge along with facet arthropathy result in mild spinal canal stenosis and mild-to-moderate bilateral neural foraminal stenosis.L5-S1: A small central protrusion result in mild central spinal canal stenosis. Along with facet arthropathy, there is moderate-to-severe left and mild-to-moderate right foraminal stenoses.
1. Multilevel degenerative lumbar spondylosis, including moderate spinal canal narrowing at L3-L4 and moderate-to-severe left and mild-to-moderate right neural foraminal narrowing at L5-S1.2. Suggestion of mild Baastrup disease at multiple levels.3. Multiple probable bilateral renal cysts, which are otherwise incompletely characterized. A renal ultrasound may be useful for further evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.