 Images are slightly limited by patient motion. The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is no pathological enhancement. The distal spinal cord and conus are within normal limits with the conus terminating at the L2 level. No abnormal postcontrast enhancement is visualized. There is developmental narrowing of the lower lumbar spinal canal with prominent dorsal and ventral epidural fat.On sagittal views, T10-T11 and T11-T12 discs demonstrate mild diffuse disc bulges without significant neuroforaminal stenosis or central spinal stenosis.T12-L1 demonstrates a right paracentral disc protrusion causing mild right neural foraminal narrowing without spinal canal stenosis. There is left greater than right ligamentum flavum and facet hypertrophic degenerative change. L1-L2 demonstrates a central disc protrusion causing mild spinal canal stenosis and mild left neuroforaminal stenosis without right neuroforaminal stenosis. Hypertrophic degenerative changes of the facets and ligamentum appears similar to prior examination. L2-L3 demonstrate mild disk disease and mild bilateral facet and ligamentum flavum degenerative changes with associated mild to moderate left neuroforaminal narrowing. There is moderate spinal canal stenosis primarily on the basis of developmental narrowing. L3-L4 demonstrates mild degenerative disk disease with subtle loss of disk height, moderate bilateral facet and ligamentum flavum hypertrophic changes. There is moderate spinal canal stenosis primarily on the basis of developmental narrowing. L4-L5 demonstrates moderate disk disease with loss of disk height and moderate bilateral facet and ligamentum flavum hypertrophic changes. There is a diffuse disc bulge with a right paramedian prominence causing mild to moderate right neuroforaminal stenosis without spinal canal stenosis or left neural foraminal stenosis. There is a right far lateral annular fissure. L5-S1 demonstrates minimal disk disease and moderate bilateral facet and ligamentum flavum hypertrophic changes. No central spinal stenosis or neural foraminal compromise.Degenerative changes of the bilateral sacroiliac joints are partially visualized.
1. No evidence for metastatic disease to the lumbar spine. 2. No significant interval change in multilevel spondylotic changes. Moderate spinal canal stenosis at L2-L3 predominantly on the basis of developmental narrowing with superimposed disc and facet/ligamentous hypertrophic degenerative disease causing mild to moderate left neuroforaminal narrowing.3. There is moderate central spinal canal stenosis at L3-L4 primarily on the basis of developmental narrowing. 4. There is stable right far lateral annular fissure involving the L4-L5 disc with right paramedian prominent disc bulge causing mild to moderate right neuroforaminal stenosis.