Right lower extremity pain and weakness. Evaluate for spinal canal and neural foraminal stenosis. Please note for the purposes of numbering there are 5 nonrib-bearing lumbar type vertebral bodies and a 6th transitional segment labeled L6. There is mild depression involving the superior endplate of L2 and unchanged from prior CT from 2/25/2010. Vertebral body heights are otherwise within normal limits. There is heterogeneous bone marrow signal without discrete suspicious lesions. There is grade 1 anterolisthesis of L4 and L5 and minimal anterolisthesis of L5 on L6. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: Disc bulge and ligamentum flavum thickening. No spinal canal or right neural foraminal stenosis. Mild left neural foraminal narrowing.L2-L3: Disc bulge with ligamentum flavum thickening and mild spinal canal stenosis. Mild bilateral neural foraminal narrowing.L3-L4: Disc bulge, ligamentum flavum thickening with mild to moderate spinal canal stenosis. Mild bilateral neural foraminal narrowing.L4-L5: Disc uncovering and disc bulge, anterolisthesis, facet arthropathy, and ligamentum flavum thickening. There is resulting severe spinal canal stenosis, moderate right and severe left neural foraminal stenosis.L5-L6: Disc uncovering and disc bulge, advanced bilateral facet arthropathy, anterolisthesis, and ligamentum flavum thickening. There is resulting moderate spinal canal stenosis. There is mild bilateral bilateral neural foraminal narrowing. L6-S1: Transitional anatomy with articulation with the sacrum greater on the left than the right. No significant disc disease. No spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
1. Please note for the purposes of numbering, there is transitional anatomy with nonrib-bearing 5 lumbar type vertebral bodies and a transitional segment labeled L6.2. Advanced degenerative changes in the lumbar spine with severe spinal canal stenosis at L4-L5 and to a lesser degree at L5 -L6 and L3-L4. Neural foraminal narrowing as detailed above, worst at L4-L5 where there is severe left and moderate right neural foraminal stenosis.