Pain and radiculopathy, lumbar region Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of L4 on L5, which is also seen on prior radiograph from 8/6/2014. Alignment is otherwise within normal limits. Bone marrow signal is benign with T1 hyperintense foci involving the T12 and anterior superior L4 vertebral bodies compatible with hemangiomas. The conus medullaris is normal in position.There is evidence of prior right L5 laminectomy. Multilevel degenerative changes are seen with multilevel disc height loss, severe at the L5-S1 level. Vacuum disc phenomena is noted at the L3-L4 and L4-L5 levels. Additional details as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: There is a small left paracentral disc extrusion which partially effaces the left lateral recess. There is no significant central spinal canal or neural foraminal stenosis. L3-L4: There is a disc bulge and left foraminal protrusion as well as mild facet arthropathy and ligamentum flavum thickening. There is partial effacement of the left lateral recess. There is mild to moderate left neural foraminal stenosis. No significant central spinal canal stenosis or right neural foraminal stenosis. L4-L5: There is moderate bilateral facet arthropathy with distention of the facet joints, grade 1 anterolisthesis, small disc extrusion with mild cranial extension, and ligamentum flavum thickening. There is moderate central spinal canal stenosis. There is mild narrowing of the right neural foramen. Left neural foramen is patent.L5-S1: Prior right-sided laminectomy. There is osteophyte and associated disc which efface the right lateral recess with contact of the right S1 nerve root. There is no significant central spinal canal stenosis. Minimal narrowing of the neural foramina.
1. Degenerative grade 1 anterolisthesis at the L4-L5 level which can be further assessed with dynamic radiographs if clinically warranted. There is mild to moderate central spinal canal stenosis at this level.2. No high-grade neural foraminal stenosis at any level. There is partial effacement of the lateral recesses at the left L2-L3, left L3-L4, and right L5-S1 levels as well as mild to moderate left L3-L4 neural foraminal stenosis. Please see additional details above.3. Prior right-sided laminectomy at the L5-S1 level. If patient has symptoms of right S1 radiculopathy, postcontrast sequence to assess extent of scar tissue may be helpful.