Chronic low back pain with bilateral radiation. For the purpose of level numbering, there are 5 lumbar-type, nonrib-bearing vertebrae. The last well-formed disc is at L5-S1.Sagittal alignment is notable for straightening. The vertebral bodies are preserved in height. There is desiccation without significant height loss involving L3-L4, L4-L5 and L5-S1 discs. There is no suspicious marrow abnormality. There is mild right sided degenerative marrow signal subjacent to the L5-S1 endplate. Similar focal changes present along small interbody herniations along the inferior endplates of L3 and L4. Small, focal T1/T2-hyperintense lesions involving the inferior right posterolateral aspect of L1 vertebral body and the base of the right L3 transverse process most likely represent hemangiomas.The conus medullaris is unremarkable. The tip of the conus medullaris lies at mid L2 level.T10-T11 and T11-T12 are only covered on sagittal imaging and there is no significant spinal canal stenosis.T12-L1, L1-L2, and L2-L3: There is no disc herniation. There is no spinal canal or foraminal stenosis.L3-L4: There is mild disc bulge eccentric to the left. There is mild left worse than right facet arthropathy and ligamenta flava thickening. There is mild left foraminal stenosis. There is no spinal canal or right foraminal stenosis.L4-L5: Minimal disc bulge results in no significant spinal canal or foraminal stenosis. Mild bilateral facet arthropathy.L5-S1: Disc bulge with a small central protrusion is associated with mild-to-moderate right facet arthropathy. There is mild right neural foraminal narrowing.Asymmetric, infiltrative fat intensity within the left posterior paraspinal muscles at L2 level is probably an intramuscular lipoma.
1. Mild degenerative changes in the lumbar spine. There is no significant spinal canal stenosis at any level. There is mild left L3-L4 and right L5-S1 neural foraminal narrowing. No high-grade neural foraminal stenosis. 2. There is facet arthropathy from L3-L4 to L5-S1 levels, relatively worse at the right L5-S1 level.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.