Back pain and left foot numbness. There is grade 1 degenerative anterolisthesis of L3 on L4, but the remaining vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. The imaged distal spinal cord displays normal signal and morphology. The conus medullaris tip is located at the level of L1. At T11-12, there is a small posterior disc bulge on sagittal view causing mild canal stenosis, but no significant neural foraminal stenosis. At T12-L1, there is no significant central or neural foraminal stenosis. At L1-L2, there is mild facet joint hypertrophy, but no significant central or neural foraminal stenosis. At L2-L3, there is bilateral paracentral disc bulges and facet joint hypertrophy result in mild central stenosis, but no significant neural foraminal stenosis. At L3-L4, a disc bulge and facet joint hypertrophy result in severe spinal canal stenosis, mild right and moderate left neural foraminal stenosis. There is also a posterior 8 mm diameter heterogeneous left synovial cyst. At L4-L5, a disc bulge and facet joint hypertrophy result in moderate spinal and right neural foraminal stenosis and mild to moderate left neural foraminal stenosis. At L5-S1, there is bilateral facet joint hypertrophy, but no significant spinal canal or neural foraminal stenosis.
Multilevel degenerative spondylosis, which is most pronounced at L3-4, with severe spinal canal stenosis and moderate left neural foraminal stenosis, and at L4-5, with moderate spinal canal stenosis and mild to moderate left neural foraminal stenosis. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.