Low back and right lower extremity pain Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild exaggeration of lumbar lordosis. Alignment is otherwise within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.There is congenitally narrow lumbar spinal canal with superimposed degenerative changes as described below: T11-T12: Mild disc bulge with mild to moderate spinal canal stenosis based on sagittal sequences. Moderate right and mild left neural foraminal narrowing.T12-L1: There is mild disc bulge and bilateral facet arthropathy, and ligamentum flavum thickening resulting in mild to moderate spinal canal narrowing. There is mild narrowing of the neural foramina.L1-L2: There is mild to moderate spinal canal stenosis related to bilateral facet arthropathy and ligamentum flavum thickening. There is mild bilateral neural foraminal stenosis.L2-L3: There is moderate spinal canal stenosis related to prominent bilateral facet arthropathy and ligamentum flavum thickening. Minimal disc bulge. There is mild to moderate left and mild right neural foraminal stenosis.L3-L4: There is severe spinal canal stenosis related to advanced bilateral facet arthropathy, ligamentum flavum thickening, and mild disc bulge. There is mild bilateral neural foraminal narrowing.L4-L5: There is moderate spinal canal stenosis related to advanced facet arthropathy and ligamentum flavum thickening. There is effacement of the lateral recesses. Minimal disc bulge. There is no significant neural foraminal stenosis. L5-S1: There is mild to moderate spinal canal narrowing related to bilateral facet arthropathy and minimal disc bulge. There is effacement of the bilateral lateral recesses. There is moderate to severe neural foraminal stenosis bilaterally, right relatively worse in left.There appears to be surgical scar involving the midline lower paraspinous tissues which can be correlated with prior history. Due to the advanced facet arthropathy, small laminectomy defects are difficult to delineate with MRI. Paraspinous soft tissues are otherwise grossly within normal limits.
1. Advanced multilevel degenerative changes in the lumbar spine. There is severe spinal canal stenosis at L3-L4, moderate spinal canal stenosis at L2-L3 and L4-L5, and mild to moderate at additional levels in the lumbar and lower thoracic spine as described above.2. Moderate to severe neural foraminal stenoses bilaterally at L5-S1, right relatively worse than left.3. Advanced facet arthropathy throughout the lumbar spine.