Severe L4 pain radiating left sciatic, T12 lipoma. Patient has history of allergic reaction and premedicated. Five lumbar type vertebral bodies are presumed to be present. There is significant dextroscoliosis of the lumbar spine with apex at the L2-L3 level. Vertebral body heights are within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.There is significant loss of disc height involving the left aspect of the L2-L3 level with prominent left-sided lateral osteophytes. There are associated edematous endplate marrow signal changes at the L2-L3 level. Individual levels as below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Severe loss of disc space involving the left aspect of the disc, edematous endplate marrow signal changes, minimal bulge, and advanced left-sided facet arthropathy. There is moderate left-sided neural foraminal stenosis with possible impingement of the left L2 nerve root. There is partial effacement of the left lateral aspect of the thecal sac related to the facet arthropathy, otherwise no significant central canal stenosis at this level. No significant right neural foraminal stenosis.L3-L4: Small central disc protrusion. No spinal canal or neural foraminal stenosis.L4-L5: Minimal disc bulge. No spinal canal or neural foraminal stenosis. Bilateral facet arthropathy.L5-S1: Loss of intervertebral disc space and mild bulge. Bilateral facet arthropathy. No significant spinal canal or neural foraminal stenosis.There is enhancement related to the L2-L3 degenerative changes. No suspicious enhancement or masses in the spine or paraspinous soft tissues are appreciated.
Advanced degenerative changes at the left L2-L3 level related to dextroscoliosis. There is moderate left-sided neural foraminal stenosis and possible impingement of the exiting left L2 nerve root. No significant spinal canal or neural foraminal stenosis elsewhere in the lumbar spine.