Severe low back pain, radiating down both legs. Concern for sciatica/nerve compression. There is transitional anatomy at the lumbosacral junction with 5 conventional lumbar type vertebral bodies and a sixth transitional segment labeled L6 for the purposes of this report which articulates with the sacrum on the left.Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. There is a thin linear T1 hyperintense structure within the thecal sac likely related to radicular vein and normal variant.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: No significant disc disease. No spinal canal or neural foraminal stenosis.L5-L6: There is moderate bilateral facet arthropathy, worse on the left than the right. There is also a small right central disc extrusion with mild cranial migration. There is partial effacement of the lateral recesses with contact of the descending nerve roots, relatively greater on the right than the left. No significant central spinal canal stenosis. There is fairly mild narrowing of the bilateral neural foramina.L6-S1: No significant disc disease. Spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
1. Transitional lumbosacral anatomy with a transitional lumbarized segment which articulates with the sacrum on the left labeled L6 for the purposes of this report.2. Moderate facet arthropathy at the L5-L6 level, relatively worse on the left than the right.3. Small disc extrusion at the L5-L6 level which along with facet arthropathy contribute to partial effacement of the lateral recesses and contact of the descending nerve roots, relatively greater on the right than the left. There is very mild narrowing of the L5-L6 neural foramina, and no high-grade neural foraminal stenosis at any level. There is also no significant central spinal canal stenosis at any level. 