Left lateral recess syndrome. Spinal stenosis. For the purposes of numbering, the first nonrib-bearing vertebral bodies labeled L1. As such there are 4 lumbar type vertebral bodies and a sacralized transitional segment labeled S1. Vertebral body heights are within normal limits. Alignment is within normal limits aside from minimal anterolisthesis of L3 on L4. Bone marrow signal is benign. The conus medullaris is normal in position.Mild disc bulges are present in the lower thoracic spine without significant spinal canal stenosis or neural foraminal stenosis based on sagittal images. Multilevel degenerative changes in the lumbar spine, as described below:T12-L1: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L1-L2: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge, ligamentum flavum thickening, and facet arthropathy. No significant spinal canal stenosis. There is mild bilateral neural foraminal stenosis.L3-L4: Disc bulge, advanced facet arthropathy, and ligamentum flavum thickening contribute to moderate spinal canal stenosis including effacement of the bilateral lateral recesses. There is also mild to moderate bilateral neural foraminal stenosis. Mild distention of the facet joints. Minimal anterolisthesis.L4-S1: Disc bulge and moderate bilateral facet arthropathy. There is some loss of disc height, degenerative endplate changes and vacuum phenomena. There is partial effacement of the lateral recesses, left worse than right. There is no significant central spinal canal stenosis. There is moderate to severe left and moderate right neural foraminal stenosis. There are multiple bilateral renal cysts. There is an exophytic lesion involving the left kidney with T2 hypointensity which is partially imaged, favored to represent a cyst with hemorrhage and grossly similar to CT chest dated 3/2/2009.
1. Please note transitional lumbosacral junction anatomy as described above with the most inferior well-defined disc space labeled L4-S1.2. Multilevel degenerative changes, relatively worse at the L3-L4 and L4-S1 levels. There is moderate spinal canal stenosis at the L3-L4 level. At L4-S1 level, there is no significant central spinal canal stenosis although there is effacement of the lateral recesses, particularly on the left. There is minimal anterolisthesis of L3 on L4 which can be further assessed with dynamic radiographs as clinically indicated.3. Neural foraminal stenosis is worst at the L4-S1 level where there is moderate to severe left and moderate right neural foraminal stenosis.4. Multiple renal cysts are noted but not well evaluated. Please see comment above.