61-year-old male with history of chronic back pain. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. A peripherally enhancing Schmorl's node is present along the inferior endplate of L4. The conus medullaris is normal in position terminating at the level of L1. No abnormal enhancement to suggest infection.Multilevel degenerative changes are seen, as described below:T12-L1: No significant disc disease. No significant spinal canal or neuroforaminal stenosis.L1-L2: No significant disc disease. No significant spinal canal or neuroforaminal stenosis.L2-L3: Minimal disc bulge and facet arthropathy. No significant spinal canal stenosis. Minimal bilateral neuroforaminal stenosis.L3-L4: Mild disc bulge and small left annular fissure. There is facet hypertrophy. Mild to moderate left neuroforaminal narrowing. No significant right neural foraminal narrowing.L4-L5: There is a left paracentral extrusion with slight superior migration, mild facet and ligamentum flavum hypertrophy resulting in moderate left and mild right neuroforaminal narrowing. No significant spinal canal stenosis. Minimal T2 hyperintensity in the disc is compatible with degenerative change. L5-S1: Advanced bilateral facet arthropathy. Mild disc bulge with facet and ligamentum flavum hypertrophy resulting in mild to moderate bilateral neural foraminal stenosis. Possible pars defect on the right. There are bilateral facet effusions.The paraspinous soft tissues are within normal limits.
1. Multilevel degenerative changes of the lumbar spine as above, relatively worse at the L4-5 level where there is disc extrusion and moderate left neuroforaminal narrowing. No significant spinal canal stenosis at any level.2. Advanced bilateral facet arthropathy at L5-S1 which may be contributing to patient's low back pain. 3. No evidence of discitis-osteomyelitis or epidural abscess.