bilateral lower extremity pain, numbenss, inability to walk. For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There are significant degenerative change of lumbar spine including intervertebral disc degenerations on L34, L45 and L5S1 with MODIC type 2 changes.There is also grade 1 spondylolisthesis of L2 on L3 which most likely related to degenerative changes of facet joint.The conus medullaris terminates at the T12-L1 level. And the spinal cord signal intensity is normal.Paraspinal soft tissue is normal.No evidence of compression fracture.Degenerative changes are specified by the intervertebral level as follows: L1-L2: Diffuse bulging of disc with bilateral ligamentum flavum thickening creating mild spinal stenosis. L2-L3: Diffuse bulging of disc with bilateral ligamentum flavum thickening results severe spinal stenosis. Bilateral neural foraminal stenosis is also moderate to severe degree (left worse than right) L3-L4: Diffuse bulging of disc with bilateral ligamentum flavum thickening results severe spinal stenosis. Bilateral neural foraminal stenosis is also seen in moderate to severe degree. L4-L5: Diffuse bulging of disc with focal broad based disc bulging results severe right side neural foraminal stenosis as well as right lateral recess stenosis. L5-S1: Diffuse bulging of disc. Bilateral neural foraminal stenosis, severe degree.
Advanced degenerative spondylosis including grade 1 spondylolisthesis of L2 on L3, spinal stenosis from L34 to L45 level and multilevel various degreed neural foraminal stenosis as described above.Spinal cord signal intensity appears to be normal.