Back pain and sciatica, evaluate for herniated disc or spinal stenosis Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. There is minimal fibrofatty infiltration of the filum terminale measuring less than 2 mm. The conus medullaris is normal in position. Limited evaluation of the lower thoracic spine demonstrates a disc bulge at the T11-T12 level without significant spinal canal or neural foraminal stenosis.Multilevel degenerative changes are seen in the lumbar spine, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: There is a disc bulge with small right paracentral protrusion. There is also mild ligamentum flavum thickening, mild facet arthropathy, and prominence of the epidural fat which all contribute to mild to moderate spinal canal stenosis at this level. There is mild bilateral neural foraminal narrowing L4-L5: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L5-S1: Evidence of remote left-sided laminotomy. Significant loss of disc height and degenerative fatty endplate marrow signal changes. There is a disc bulge with left foraminal disc protrusion. There is prominent facet arthropathy on the left. There is moderate narrowing of the left neural foramen related to a disc material, endplate osteophyte, and facet arthropathy. There is minimal narrowing of the right neural foramen. No significant central canal stenosis. Paraspinous soft tissues are within normal limits.
Degenerative changes in the lumbar spine. There is mild to moderate spinal canal stenosis at the L3-L4 level. There is also moderate left L5-S1 neural foraminal stenosis with possible impingement of the left L5 nerve root. Please see details above.