Pain and numbness in bilateral lower extremities. Alignment is anatomic. The vertebral body heights are preserved. Degenerative endplate marrow signal abnormality as well as contour irregularity is present on multiple endplates most notably at L2-3. Severe disc degeneration at L2-3 without increased T2 signal to suggest an acute inflammatory or infectious process. No extra axial masses or fluid collections are identified. No abnormality in the visualized soft tissues. Level by level findings are as follows:L1-L2: No disc bulge, spinal canal stenosis, or neuroforaminal narrowing.L2-L3: Severe disc degeneration with moderate diffuse disc bulge and superimposed focal right paracentral herniation. Moderate facet and ligamentum flavum hypertrophy. Mild left and moderate to severe right neuroforaminal stenosis and mild spinal canal stenosis.L3-L4: Mild diffuse disc bulge, facet hypertrophy, and ligamentum flavum hypertrophy create mild right and minimal left neural foraminal stenosis. Moderate spinal canal stenosis.L4-L5: Moderate to severe facet arthropathy and hypertrophy of the ligamentum flavum. There is mild right neuroforaminal narrowing. No spinal canal stenosis.L5-S1: Moderate to severe facet arthropathy and hypertrophy of the ligamentum flavum creating mild bilateral neural foraminal narrowing. No significant spinal canal stenosis.
1. Severe degeneration at L2-3 with associated chronic endplate changes and advanced degeneration of the facet joints. This results in moderate to severe right neural foraminal stenosis. Given the advanced disc degeneration at this level compared to the others in the lumbar spine, this raises the possibility of a remote traumatic or inflammatory process at this level.2. Scattered multilevel degenerative changes in the rest of the lumbar spine which create multiple mild neural foraminal narrowings.