Progressive neuropathy, assess for lumbar radiculopathy, neurolymphomatosis. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is straightening of the lumbar spine curvature and minimal L5 on S1 retrolisthesis. Alignment is otherwise maintained. Advanced degenerative changes are seen throughout the lumbar spine with moderate loss of height at all levels. Associated fatty endplate marrow signal changes are noted. No destructive lesions are demonstrated. There is a focus of susceptibility at the posterior-inferior aspect of the L3 vertebral body consistent with gas and likely on a degenerative basis. The conus medullaris is normal in position.Individual levels as described below:L1-L2: Mild disc bulge, facet arthropathy, and ligamentum flavum thickening. No significant spinal canal stenosis. There is mild bilateral neural foraminal narrowing. L2-L3: Mild disc bulge, epidural lipomatosis, facet arthropathy, and ligamentum flavum thickening resulting in moderate spinal canal stenosis. There is mild to moderate right and mild left neural foraminal stenosis.L3-L4: There is disc bulge with small right paracentral protrusion and osteophyte resulting in effacement of the right lateral recess. There is also facet arthropathy and ligamentum flavum thickening which contribute to mild-to-moderate central canal stenosis. There is mild to moderate right and mild left neural foraminal stenosis.L4-L5: There is disc bulge, ligamentum flavum thickening, and bilateral facet arthropathy resulting in moderate spinal canal stenosis. There is moderate right and moderate to severe left neural foraminal stenosis.L5-S1: Minimal disc bulge and endplate osteophytes result in effacement of the left lateral recess. No significant central canal stenosis. There is mild right and moderate left neural foraminal stenosis. There is bilateral facet arthropathy.Paraspinous soft tissues are within normal limits. No soft tissue masses are seen.
1. Advanced degenerative changes in the lumbar spine with moderate spinal canal stenosis at L2-L3 and L4-L5. There is also significant neural foraminal stenosis at multiple levels, as detailed above.2. No masses or abnormal enhancement involving the lumbar spine or spinal canal/cauda equina nerve roots to suggest lymphomatous involvement.`