79-year-old male with pain. Evaluate for spinal stenosis. For the purposes of numbering, there are 5 lumbar-type vertebral bodies. There is grade 1 anterolisthesis of L3 on L4 as well as mild levocurvature of the lumbar spine with apex at the L3-L4 level. There is severe multilevel degenerative disc disease at L3-4, L4-5, and L5-S1 which results in severe central canal stenosis and compression of nerve roots at these levels. There is endplate related degenerative marrow signal abnormality without acute fracture. There is redundancy of the nerve roots due to central stenosis, but the distal spinal cord and conus medullaris appear unremarkable. Additional level specific findings are as follows:T12-L1: No significant degenerative disc disease, central canal, or neural foraminal stenosis.L1-L2: No significant degenerative disc disease, neural foraminal, or central canal stenosis.L2-3: Mild degenerative disc disease with disc bulge and mild facet degenerative changes result in mild central canal stenosis. There is no significant neural foraminal stenosis.L3-4: Moderate degenerative disc disease with superior disc extrusion along the posterior inferior L3 vertebral body. These findings along with severe facet hypertrophic degenerative changes result in severe central stenosis and compression of nerve roots at this level. There is severe right and mild left neural foraminal stenosis.L4-5: Moderate degenerative disc disease with disc bulge and severe hypertrophic facet degenerative changes results in severe central canal stenosis with compression of nerve roots at this level. There is severe left neural foraminal narrowing. There is no significant right neural foraminal narrowing.L5-S1: Degenerative disc disease and severe hypertrophic facet degenerative changes result in moderate central canal stenosis and severe bilateral neural foraminal stenosis.
1. Severe lumbar degenerative disc disease and hypertrophic facet degenerative changes results in severe central canal stenosis at L3-4 and L4-5. There is also mild to moderate canal stenosis at L2-3 and L5-S1.2. Severe neural foraminal stenosis on the right at L3-4, on the left at L4-5, and bilaterally at L5-S1.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.