Right-sided sciatica pain, evaluate for evidence of spinal stenosis and degree of degenerative disc disease. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild straightening; alignment in the lumbar spine is otherwise maintained. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are seen with particular disc height loss at the L4-L5 and L5-S1 levels with vacuum phenomena as well as edematous marrow signal changes involving the L5 and S1 endplates. Additional details as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge eccentric to the right without significant spinal canal stenosis. There is mild right neural foraminal narrowing as well as contact of the disc with the extraforaminal right L2 nerve root. Left neural foramen is patent. Bilateral facet arthropathy, with distention of the right facet joint.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: There is disc bulge eccentric to the left as well as facet arthropathy, worse on the left than the right. There is no significant spinal canal or right neural foraminal stenosis. There is moderate left neural foraminal stenosis.L5-S1: Disc bulge and moderate bilateral facet arthropathy. No significant spinal canal stenosis. There is moderate bilateral neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
1. Multilevel degenerative changes in the lumbar spine without significant spinal canal stenosis at any level. There is mild right L2-L3 and moderate right L5-S1 neural foraminal stenosis as well as moderate left L4-L5 and left L5-S1 neural foraminal stenosis. Additional details as above.2. Endplate degenerative changes are worse at the L4-5 and L5-S1 levels. There is also facet arthropathy at L2-L3, L4-L5, and L5-S1 levels, which may also be contributing to back pain.