Low back pain [M54.5], Reason for Study: ^Reason: evaluate for neuroforaminal stenosis History: lumbago, sciatica, hx osteoporosis For the purposes of numbering, the lower most fully formed vertebral disc space is considered the L5-S1 intervertebral disc space. There is a lumbarized S1.There is straightening of the lumbar lordosis. Mild to moderate endplate irregularity with edema is demonstrated at L5-S1. Otherwise, the vertebral body heights are maintained. There is mild loss of intervertebral disc space at T12-L1 and moderate loss of intervertebral disc space at L5-S1. The conus terminates at distal L1. The visualized spinal cord and cauda equina demonstrate normal signal intensity and morphology. No focal worrisome marrow signal or abnormal postcontrast enhancement is identified.T11-12: No significant disc herniation, neuroforaminal stenosis, or spinal stenosis is noted at this level.T12-L1: There is a small right paracentral abutting the right anterior spinal cord. No significant neuroforaminal stenosis is noted.L1-2: No significant disc herniation, neuroforaminal stenosis, or spinal stenosis is noted at this level.L2-3: No significant disc herniation, neuroforaminal stenosis, or spinal stenosis is noted at this level.L3-4: No significant disc herniation, neuroforaminal stenosis, or spinal stenosis is noted at this level.L4-5: There is a disc bulge resulting in mild neuroforaminal narrowing bilaterally. There is also epidural lipomatosis deforming the left posterior lateral thecal sac (series 900, image 30). There are moderate bilateral facet degenerative changes with bilateral facet effusions.L5-S1: There is a diffuse disc bulge resulting in moderate bilateral neuroforaminal stenosis and mass effect on the traversing bilateral S1 nerve roots. There is also anterior and posterior epidural lipomatosis resulting in central spinal stenosis. There are moderate bilateral facet degenerative changes.
1. Anterior and posterior epidural lipomatosis from L4 to S1 levels contributes to central spinal stenosis. 2. There is a diffuse disc bulge at L5-S1 resulting in moderate bilateral neuroforaminal stenosis with compression of the bilateral traversing S1 nerve roots.3. At L4-5 there is a diffuse disc bulge resulting in mild bilateral neuroforaminal stenosis.4. There are moderate facet degenerative changes at L4-5 and L5-S1.