 The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body heights are well-maintained. There is interval progression of moderate loss of disc height at L1-L2 with probable vacuum disc phenomenon. There is STIR signal abnormality at the superior endplate of L2 and inferior endplate of L4, corresponding to areas of Schmorl's nodes. There is diffuse hypointense marrow signal. The distal spinal cord and conus are within normal limits with the conus terminating at the L1 level.T12-L1: Bilateral facet degeneration. No significant disc bulge, spinal canal or foraminal stenosis. L1-L2: Disc bulge with superimposed central disc protrusion and bilateral facet degeneration, contributing to mild spinal canal stenosis and moderate bilateral foraminal stenosis. L2-L3: Disc bulge with superimposed central disc protrusion and bilateral facet degeneration, contributing to mild spinal canal stenosis and mild bilateral foraminal stenosis. L3-L4: Disc bulge, thickening of the ligamentum flavum and bilateral facet degeneration, contributing to mild spinal canal stenosis and mild bilateral foraminal stenosis. L4-L5: Disc bulge, thickening of the ligamentum flavum and bilateral facet degeneration, contributing to mild spinal canal stenosis and moderate right and mild left foraminal stenosis. L5-S1: Disc bulge, thickening of the ligamentum flavum and bilateral facet degeneration, contributing to mild spinal canal stenosis and moderate left and mild right foraminal stenosis.
1. Advanced degenerative changes of the lumbar spine with multilevel foraminal and spinal canal stenosis as described above, with interval progression particularly at L1-L2 and L4-L5.2. Interval progression of facet arthropathy throughout the lumbar spine, which may contribute to patient's symptoms.3. Diffuse hypointense marrow signal, which may be related to patient's endstage renal disease or as chronic anemia.  