Spinal stenosis Five lumbar type vertebral bodies are presumed to be present. Bone marrow signal is benign. The conus medullaris is normal in position. Vertebral body heights are within normal limits. There is minimal retrolisthesis of L2 on L3 and L3 on L4 and grade 1 anterolisthesis of L4 and L5. There is mild left lateral subluxation of L4 and L5. There is mild levoscoliosis of the lumbar spine with apex at the L4-L5 level. Disc desiccation with vacuum phenomena noted at the L2-L3, L3-L4, and L4-L5 levels. There is particular height loss involving the right aspect of the L4-L5 disc space. Small Schmorl's nodes are evident in the lower thoracic spine as well as at the inferior endplate of L2. Advanced degenerative changes at the T11-T12 level are also noted. These findings are also evident on prior CT. Mild enlargement of the spinous processes is noted which are contacting, with T2 hyperintensity noted at the L3-L4 interspinous level; findings suggestive of bursitis/Baastrup's disease. Individual levels as below:L1-L2: Minimal disc bulge, facet arthropathy, and ligamentum flavum thickening. No significant spinal canal or neural foraminal stenosis. L2-L3: Minimal disc bulge, facet arthropathy, and ligamentum flavum thickening. No significant spinal canal or neural foraminal stenosis. L3-L4: Disc bulge with a component of right paracentral extrusion. There is also facet arthropathy and prominent ligamentum flavum thickening. There is moderate to severe central spinal canal stenosis and effacement of the right lateral recess. There is moderate to severe right and mild to moderate left neural foraminal stenosis.L4-L5: There is disc uncovering and mild bulge as well as a small right paracentral protrusion. There is advanced bilateral facet arthropathy as well as ligamentum flavum thickening. There is moderate to severe spinal canal stenosis. There is mild to moderate right and minimal left neural foraminal stenosis.L5-S1: Mild disc bulge. There is advanced bilateral facet arthropathy. No significant central canal stenosis. There is mild to moderate left neural foraminal stenosis. Right neural foramen is patent. Paraspinous soft tissues demonstrate fatty atrophy involving the lower lumbar paraspinous musculature, but are otherwise unremarkable. Small right renal cyst.
1. Advanced multilevel degenerative changes with moderate to severe spinal canal stenosis at the L3-L4 and L4-L5 levels. Multilevel neural foraminal stenosis is worst at the right L3-L4 level, where there is also effacement of the right lateral recess related to right paracentral disc extrusion. Additional levels as above.2. Advanced facet arthropathy at the L4-L5 and L5-S1 levels. There is mild left lateral subluxation as well as grade 1 anterolisthesis of L4 on L5; there is also lumbar levoscoliosis with apex at this level.3. Contacting spinous processes at L3-L4 with interspinous T2 hyperintensity suggestive of Baastrup's disease..