Chronic lower back pain, evaluate for spinal stenosis versus facet disorder. Five lumbar type vertebral bodies are presumed to be present. There is grade 1 retrolisthesis of L4 on L5 measuring 5 mm as well as minimal grade 1 retrolisthesis of L5 on S1. The vertebral body heights are well-maintained. There is a small Schmorl's node in the inferior endplate of L4. No focal marrow signal abnormality is appreciated. There is diffuse disc desiccation and mild multilevel disc narrowing with relative sparing of L5-S1. The conus medullaris terminates at mid-L2. There is bilateral sclerosis and narrowing of the sacroiliac joints. There is abnormal intrinsic thin linear T1 hyperintensity along the midline dorsal thecal sac from L2 to L3 to the distal end of the thecal sac, measuring less than 1 mm in thickness.T12-L1: There is no significant spinal canal or neural foraminal narrowing. L1-L2: There is a shallow left foraminal disc protrusion with mild facet arthropathy as well as mild left neural foraminal narrowing. There is no significant right neural foraminal narrowing or spinal canal narrowing.L2-L3: There is a trace disc bulge with left foraminal prominence with abutment of the descending left L3 nerve root. There is a left paramedian annular fissure. There is mild left facet arthropathy. There is moderate left neural foraminal narrowing. There is no significant right neural foraminal narrowing or spinal canal narrowing.L3-L4: There is a diffuse disc bulge as well as a thickened ligamentum flavum. There is left greater than right facet arthropathy. There is mild-to-moderate left neuroforaminal narrowing and mild right neural foraminal narrowing.L4-L5: There is some degree of disc uncovering with a diffuse disc bulge that indents the thecal sac. There is no significant spinal canal narrowing. There is mild to moderate left neural foraminal narrowing and severe right neural foraminal narrowing. L5-S1: There is bilateral facet hypertrophy. There is no significant neural foraminal narrowing or spinal canal narrowing.
1. Grade 1 retrolistheses of L4 on L5 and L5 on S1.2. Severe right neural foraminal stenosis at L4-L5, with mild to moderate narrowing at several other neural foramina as described above.3. Compression of the descending left L3 nerve root by a left foraminal prominence of a disc bulge.4. No significant spinal canal narrowing.5. Fatty filum terminale with normal conus termination. This is a normal variant but can be seen with a tethered cord. Please correlate clinically.