76-year-old female with severe lower back pain. Evaluate for spinal stenosis, disc herniations. Five lumbar type vertebral bodies are presumed to be present which are appropriate in in height. Moderate levoscoliosis is present with apex at the L4-5 level. There is mild right lateral subluxation of L2 on L3 and left lateral subluxation of L4 on L5. Mild grade 1 anterolisthesis of L4 on L5 is also noted. Edematous marrow changes of T12 and L1 are likely degenerative in etiology. The conus medullaris on sagittal imaging is grossly intact. Fatty atrophy of the paraspinous musculature is additionally presentAt T11-T12 there is moderate disk bulge, ligamentum flavum hypertrophy and facet hypertrophy. There is no significant central canal stenosis, and there is mild left neuroforaminal compromise.At L1-2 there is mild disk bulge, ligamentum flavum hypertrophy and facet arthropathy. There is no significant central canal stenosis and mild left neuroforaminal compromise.At L2-3 there is mild disk bulge, ligamentum flavum hypertrophy, and facet hypertrophy. There is mild central canal stenosis, as well as mild bilateral neuroforaminal stenosis.At L3-4 there is mild disk bulge, ligamentum flavum hypertrophy, and severe facet hypertrophy. There is moderate central canal stenosis and mild bilateral neuroforaminal compromise.At L4-5 there is moderate disk bulge, ligamentum flavum hypertrophy and severe facet hypertrophy. There is moderate to severe central canal stenosis and moderate to severe right and mild to moderate left neuroforaminal compromise. There is also a tiny extraforaminal cyst on the left, which may represent a synovial cyst.At L5-S1 there is mild disk bulge, ligamentum flavum hypertrophy, and facet hypertrophy. There is no significant central canal stenosis. There is mild to moderate left neuroforaminal compromise.Right renal pelvic ectopia located again noted incidentally.
1.Multilevel degenerative changes of the lumbar spine, with moderate to severe central canal stenosis at L4-5 and to a lesser degree at other levels as detailed above.2.Moderate to severe right neuroforaminal compromise at L4-5, and mild to moderate on the left at L4-5 and L5-S1. 3.Moderate lumbar levoscoliosis as describe above.4.Facet arthropathy throughout the lumbar spine, relatively worse at L4-5 and L5-S1.