 For the purposes of numbering, there are 5 lumbar type vertebral bodies. Vertebral body heights are maintained. Alignment is maintained. Disc desiccation signal and mild loss of intervertebral disc height are noted at L4-5 and L5-S1. There are associated endplate degenerative bone marrow signal changes, most prominent at L5-S1. Other scattered areas of focal increased T1 and T2 signal within the vertebral bodies are likely related to focal fatty marrow and/or intraosseous hemangiomas. There is prominence of the lumbar dorsal and ventral epidural fat from the L3 to S1 levels compatible with epidural lipomatosis. Prominent facet arthropathy, particularly at the L4-5 and L5-S1 levels. The visualized portion of the distal spinal cord and conus medullaris are normal in signal and morphology. The conus medullaris terminates at the L1-2 level. Multilevel degenerative changes are seen, as describe below:At L1-2, there is no significant compromise to spinal canal or neural foramina.At L2-3, mild spinal canal stenosis, predominantly due to epidural lipomatosis. No significant neural foraminal narrowing.At L3-4, moderate spinal canal stenosis, predominantly related to epidural lipomatosis. Bilateral facet arthropathy and left foraminal to far lateral disc protrusion results in mild left neural foraminal stenosis.At L4-5, marked effacement of the thecal sac, predominantly due to epidural lipomatosis. Mild disc bulge. Marked bilateral, right greater than left, facet arthropathy. Moderate bilateral neural foraminal narrowing, worse on the right.At L5-S1, marked effacement of the thecal sac, predominantly due to epidural lipomatosis. Mild disc bulge. Marked bilateral, left greater than right, facet arthropathy. Mild to moderate left neural foraminal stenosis.Paraspinous soft tissues are within normal limits. Diffuse infiltrative appearing T1 hypointense bone marrow signal is present in the visualized portion of the right iliac bone.
1. Diffuse T1 hypointense bone marrow signal throughout the partially visualized right iliac bone. Further imaging is recommended for evaluation, starting with CT, as an infiltrating lesion cannot be excluded.2. Findings compatible with epidural lipomatosis throughout the lumbar spine resulting in stenosis of the spinal canal, which is mild at L2-3, moderate at L3-4, and severe at L4-5 and L5-S1.3. Prominent facet arthropathy throughout the lumbar spine, in particular at L4-5 and L5-S1. Moderate bilateral neural foraminal narrowing at L4-5.