 The last well formed disk space is referred to as L5-S1. There straightening of the lumbar lordosis. Vertebral body heights are preserved. There is disk desiccation at multiple levels in the lumbar spine with loss of disk height at L2-3 through L5-S1, most severe in the lower lumbar levels. There are type 2 degenerative changes at the L5-S1 endplates, and the L4-L5 endplates. There is mild edema in the L3-4 endplates and right pedicle of L4 likely secondary to advanced degenerative disease. There are scattered foci of high T1 signal within the vertebral bodies representing focal fatty deposition versus hemangiomas. The conus terminates at L1-2 and shows normal caliber and signal.T11-12: No disk herniation, central spinal canal or neural foraminal stenosis.T12-L1: No disk herniation, central spinal canal or neural foraminal stenosis.L1-2: Left foraminal/extra foraminal disk protrusion and mild disk bulge causing moderate left neural foraminal stenosis. No central spinal canal or right neural foraminal stenosis.L2-3: Diffuse disk bulge, mild bilateral facet arthropathy and ligamentum flavum thickening causing minimal bilateral neural foraminal stenosis and minimal central spinal canal stenosis.L3-4: Diffuse disk bulge, bilateral facet arthropathy and ligamentum flavum thickening causing mild central spinal canal stenosis, moderate right and minimal left neural foraminal stenosis. There is encroachment of the bilateral subarticular zones at this level.L4-5: Diffuse disk bulge asymmetric to the right, moderate bilateral facet arthropathy and ligamentum flavum thickening causing mild left greater than right neural foraminal stenosis and mild central spinal canal stenosis. Disk material encroaches upon both subarticular zones (right greater than left), with mild posterior displacement of the traversing L5 nerve roots suspected, right greater than left.L5-S1: Disk bulge and osteophytic ridging, bilateral facet arthropathy causing no significant spinal canal stenosis and mild right and moderate left neural foraminal stenosis.
1.Advanced degenerative disk and facet changes at multiple levels in the lumbar spine causing multilevel variable spinal canal and neural foraminal stenoses as detailed above.2.Particularly, there is disk material encroaching upon the subarticular zones at L4-5 (right greater than left) which may be contacting the traversing L5 nerve roots, more on the right. Additional levels of foraminal narrowing as above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.