Right lower extremity radiculopathy Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is grossly within normal limits although there is exaggerated kyphosis at the L1-L2 level and minimal anterolisthesis of L5 on S1. Bone marrow signal is benign. Conus is at the lower limits of normal at the inferior L2 level. There appears to be fatty infiltration along the filum terminale from the mid to lower L3 level to the L5-S1 levels, slightly to the left of the midline (which is unusual) and measuring up to 2 mm in diameter. Unlikely this represents a vessel given the thickness of it.There is disc desiccation throughout the lumbar spine with mild loss of disc height, relatively worse at the L1-L2 level. Additional details regarding multilevel degenerative changes, as described below:L1-L2: Mild disc bulge with small right paracentral disc protrusion. No spinal canal or neural foraminal stenosis.L2-L3: There is a central disc extrusion with mild caudal migration. There is very mild spinal canal narrowing involving the anterior thecal sac without compression of the cauda equina nerve roots. Neural foramina are also patent. Mild facet arthropathy.L3-L4: Minimal disc bulge as well as mild to moderate bilateral facet arthropathy. There is mild narrowing of the lumbar spinal canal which is predominantly on a developmental basis. Neural foramina are patent.L4-L5: Moderate bilateral facet arthropathy with small synovial cyst posterior to the left facet joint. Minimal disc bulge. There is minimal narrowing of the spinal canal. Neural foramina are patent.L5-S1: Minimal disc bulge and moderate to severe bilateral facet arthropathy. There is partial effacement of the lateral recesses, right greater than left. No significant central spinal canal stenosis. There is mild to moderate right neural foraminal stenosis. Left neural foramen is patent.Paraspinous soft tissues are within normal limits. Partially imaged sacroiliac joints demonstrate degenerative changes with suggestion of sclerosis along the iliac aspects of the joints, as seen on recent radiographs.
1. Multilevel degenerative changes in the lumbar spine. There is partial effacement of the right lateral recess and mild to moderate right-sided neural foraminal stenosis at the L5-S1 level which may be contributing to patient's right lower extremity radiculopathy. 2. Advanced facet arthropathy at L5-S1 and to a slightly lesser degree at the L4-L5 level. There is minimal L5 on S1 anterolisthesis. Please see above for additional details including L2-L3 disc extrusion.3. There appears to be fatty infiltration of the filum terminale which is noted to be slightly left of the midline. The conus terminates at the inferior L2 level which while is at the lower limits of normal, would suggest correlation with clinical signs of cord tethering to exclude this possibility.