76 years Female (DOB:10/7/1939)Reason: eval for nerve compression History: low back pain and bilateral leg numbness/paresthesiasPROVIDER/ATTENDING NAME: RODERICK H. BIRNIE RODERICK H. BIRNIE Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact. There is a sigmoid curvature to the lumbar spine.At L5-S1 there is loss of disc space height this desiccation and mild anterior subluxation of L5 on S1 associated with moderate bilateral facet ligamentum flavum hypertrophy. There is mild anterior subluxation of L5 on S1. There is mild to moderate encroachment of exiting nerve roots due to disc bulging and facet hypertrophy at this level bilaterally. There is a diffuse disc bulge with extrusion at this level. Some disc material extends behind the inferior endplate of L5. There is some epidural lipomatosis posteriorly at this level. The spinal canal appears narrowed at this level appears to be spinal stenosis at this level.At L4-5 there is loss of disc space height and endplate reactive changes at this level associated with bilateral facet and ligamentum flavum hypertrophy as well as endplate osteophytes and a diffuse disc bulge. Disc material extrudes behind the inferior aspect of L4 and also into the neural foramina bilaterally at this level and encroaches on the exiting nerve roots. There is anterior subluxation of L4 on L5 present. There are endplate reactive changes at this level which are bright on T2 STIR.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
There are degenerative changes mainly in the lower lumbar spine associated with spinal stenosis at L5-S1 and encroachment of exiting nerve roots at L4-5 and L5-S1 bilaterally. There is associated mild anterior listhesis of L4 on L5 and L5 on S1. There is a element of epidural lipomatosis at L5-S1 which contributes to the spinal stenosis at this level.