Possible disc herniation, right radicular pain. Five lumbar type vertebral bodies are present. Vertebral body heights are within normal limits. Alignment of the lumbar spine is grossly maintained with perhaps minimal anterolisthesis of L3 on L4 and L4 and L5. Bone marrow signal is benign. The conus medullaris is normal in position at the T12-L1 level.Multilevel degenerative changes are seen including disc desiccation at L3-L4 and L4-L5 and multilevel facet arthropathy which appears progressed since prior CT from 8/13/2012. Individual levels as described below: L1-L2: Small right foraminal disc protrusion with mild to moderate right neural foraminal narrowing. No spinal canal or left neural foraminal stenosis.L2-L3: Mild disc bulge without significant spinal canal or neural foraminal stenosis.L3-L4: Disc bulge eccentric to the left with annular fissure. There is also bilateral facet arthropathy which is advanced on the left. There is resulting mild to moderate right and moderate to severe left neural foraminal stenosis. There is partial effacement of the lateral recesses. Minimal central spinal canal stenosis.L4-L5: There is a diffuse disc bulge with more focal extrusion on the right effacing the right lateral recess where there may be impingement of the descending nerve root. There is also right foraminal component of the herniated disc which results in severe right foraminal stenosis and suspected impingement of the exiting right L4 nerve root. There is also mild to moderate left neural foraminal stenosis. Bilateral facet arthropathy.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis. Bilateral facet arthropathy.Paraspinous soft tissues are within normal limits.
1. Multilevel degenerative changes in the lumbar spine, worst at the L4-L5 level where disc herniation results in severe right-sided neural foraminal stenosis as well as effacement of the right lateral recess. There may be associated impingement of the exiting right L4 and descending right L5 nerve roots. 2. Additional levels including moderate to severe left L3-L4 neural foraminal stenosis as above.3. No significant central canal stenosis.4. Multilevel facet arthropathy, worst at the left L3-L4 level.