Lumbar stenosis, L4-L5 right disc protrusion, rule out spine compression. Worsening of the low back pain, weakness of bilateral legs, right greater than left, tingling and numbness bilateral legs. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. There is no abnormal enhancement.Multiple sequences are motion degraded, which slightly limit evaluation. Multilevel degenerative changes are seen, as described below:L1-L2: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: Minimal disc bulge with dorsal annular fissure. No spinal canal or neural foraminal stenosis.L4-L5: There is a disc bulge eccentric to the right with a small right lateral recess and foraminal protrusion component. Small dorsal annular fissure. There is partial effacement of the right lateral recess with contact of the right L5 nerve root. There is also mild right neural foraminal narrowing which may be affecting the right L4 nerve root. No significant central canal stenosis. Left neural foramen is patent. L5-S1: Mild disc bulge. No significant spinal canal stenosis. There is mild right and mild to moderate left neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
Degenerative changes in the lumbar spine at the L4-L5 and L5-S1 levels as above with partial effacement of the right lateral recess at the L4-L5 level as well as relatively mild L4-L5 and L5-S1 neural foraminal stenosis as described above. No high-grade spinal canal or high-grade neural foraminal stenosis at any level is appreciated.