Back and leg pain, evaluate for spondylolisthesis Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of L4 and L5 and grade 1 retrolisthesis of L5 on S1. Bone marrow signal is benign. The conus medullaris is normal in position.There is mild congenital narrowing of the lower lumbar spinal canal with superimposed degenerative changes, as described below: L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: Mild disc height loss. There is mild disc bulge, eccentric to the left, with ligamentum flavum thickening, and mild bilateral facet arthropathy contributing to mild spinal canal stenosis. There is mild to moderate left-sided neural foraminal stenosis. No significant right neural foraminal narrowing.L4-L5: Grade 1 anterolisthesis with loss of disc height. There is disc bulge eccentric to the right, ligamentum flavum thickening, and advanced facet arthropathy. There is effacement of the right lateral recess as well as severe right neural foraminal stenosis with suspected impingement of the right exiting L4 nerve root. There is also mild to moderate central canal stenosis. There is mild left neural foraminal narrowing. L5-S1: Grade 1 retrolisthesis with loss of disc height. Central disc extrusion and ligamentum flavum thickening, without significant central canal stenosis. There is mild effacement of the lateral recesses. There is mild right and moderate left neural foraminal stenosis. Paraspinous soft tissues are within normal limits. Multiple uterine fibroids noted.
Degenerative changes in the lumbar spine worst at the L4-L5 level where there is degenerative grade 1 spondylolisthesis, severe right-sided neural foraminal stenosis, and mild to moderate central canal stenosis. There is also mild to moderate left L3-L4 and moderate left L5-S1 neural foraminal stenoses. Additional details as above.