Left lower extremity radiculopathy, left S1 root compression suspected Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is minimal retrolisthesis of L5 on S1. Alignment is otherwise grossly maintained. There is severe loss of disc height at the L4-L5 and L5-S1 levels. Bone marrow signal is benign with mild edema involving the L4 and L5 endplates on a degenerative basis.. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge eccentric to the left with small left sided annular fissure. Mild facet arthropathy. There is mild to moderate left neural foraminal stenosis. No significant spinal canal or right neural foraminal narrowing.L3-L4: Mild disc bulge and and mild facet arthropathy. There is no significant spinal canal stenosis. There is mild right and mild to moderate left neural foraminal stenosis.L4-L5: There is disc bulge with ligamentum flavum thickening, mild facet arthropathy, and slight prominence of the epidural fat resulting in mild to moderate spinal canal stenosis at this level. There is effacement of the lateral recesses. There is moderate left and mild to moderate right neural foraminal stenosis.L5-S1: Disc bulge with small left paracentral protrusion which effaces the left lateral recess. There is contact and possible impingement of the descending left S1 nerve root at this level. There is ligamentum flavum thickening and mild facet arthropathy. No significant central spinal canal stenosis. Minimal bilateral foraminal narrowing. There is a 3.7 x 4.6 cm lobulated lesion with homogeneous T1 and T2 hyperintensity involving the right piriformis muscle which likely represents lipoma. Paraspinous soft tissues are otherwise within normal limits.
1. Multilevel degenerative changes in the lumbar spine as detailed above. There is effacement of the left lateral recess related to disc protrusion at the L5-S1 level which may be impinging on the descending left S1 nerve root. Additional levels of foraminal stenosis as detailed above. There is mild to moderate spinal canal stenosis at L4-L5.2. Incidentally noted is a T1 and T2 hyperintense lesion involving the right piriformis muscle which likely represents a lipoma. 