Worsening right leg sciatica and pain with new numbness/tingling in the bilateral feet. There is degenerative spondylosis in the lower lumbar spine. In particular, there is 5 mm of anterolisthesis of L4 on L5, a disc bulge with loss of disc space height and fluid content, as well as endplate degenerative signal alterations, bilateral ligamentum flavum hypertrophy, and facet hypertrophy, which result in severe spinal canal stenosis with compression of the cauda equina nerve roots, as well as mild right and moderate left neural foraminal stenosis. At L5-S1, there is exuberant bilateral facet joint arthropathy and mild disc bulging, which results in moderate-to-severe bilateral neural foraminal narrowing. There is a slight disc bulge at L3-4, without significant spinal canal or neural foraminal stenosis. There is no significant spinal canal or neural foraminal stenosis at T12 through L3 either. The vertebral body and disc space heights are preserved. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.
Degenerative spondylosis in the lower lumbar spine. In particular, there is 5 mm of anterolisthesis of L4 on L5, a disc bulge with loss of disc space height and fluid content, as well as endplate degenerative signal alterations, bilateral ligamentum flavum hypertrophy, and facet hypertrophy, which result in severe spinal canal stenosis with compression of the cauda equina nerve roots, as well as mild right and moderate left neural foraminal stenosis. At L5-S1, there is exuberant bilateral facet joint arthropathy and mild disc bulging, which results in moderate-to-severe bilateral neural foraminal narrowing. 