Low back pain radiating to ankles, left more than right. There is lack of the usual lumbar lordosis, but no spondylolisthesis. There are intravertebral disc herniations at L2 through L4, with surrounding endplate degenerative bone marrow signal alterations. The vertebral body heights are otherwise intact. The spinal cord is normal in appearance and the conus terminates at the mid L1 level. The paravertebral soft tissues are unremarkable. Additional findings by level:T12-L1: Minimal disc bulge without spinal canal stenosis or neuroforaminal narrowing.L1-L2: Mild diffuse disc bulge and hypertrophy of the right ligamentum flavum without significant spinal canal or neural foraminal stenosis.L2-L3: Mild diffuse disc bulge, minimal facet hypertrophy, and mild thickening of the ligamentum flavum without significant spinal canal or neural foraminal stenosis.L3-L4: Moderate disc bulge, facet hypertrophy, and hypertrophy of the ligamentum flavum results in mild bilateral neural foraminal stenosis, but no significant spinal canal stenosis.L4-L5: Moderate disc bulge, moderate to severe facet hypertrophy, and thickening of the ligamentum flavum with moderate bilateral neural foraminal narrowing and effacement of the left lateral recess with impingement upon the nerves roots in this region.L5-S1: Moderate disc bulge asymmetric to the left, severe facet arthropathy, and thickening of the ligamentum flavum with severe bilateral neural foraminal narrowing and considerable spinal canal narrowing with apparent impingement upon the nerve roots in the lateral recesses bilaterally.
Multilevel degenerative spondylosis of the lumbar spine, including moderate bilateral neural foraminal narrowing at L4-5 severe bilateral neural foraminal narrowing at L5-S1, as well as compression of some of the intrathecal nerves roots at these levels, particularly on the left side at L4-5.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.