63 years Male (DOB:11/30/1952)Reason: lower back pain and RLE radiculopathy History: abovePROVIDER/ATTENDING NAME: MICHAEL J LEE MICHAEL J LEE There is a transitional vertebra present. Five non-rib bearing lumbar vertebrae are presumed to be present which are appropriate in overall height. L5 is therefore partially sacralized. The left renal vein crosses at the L1 vertebral level.The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is moderate bilateral face hypertrophy and ligament flavum hypertrophy, loss of disk space height, a diffuse disk bulge present as well as disk desiccation. There is effacement of the fat at the lateral recess at this level. There is mild anterior subluxation of L4 on L5. There is effacement of fat at the lateral recesses and fat surround in the exiting nerve roots within the neural foramina resulting encroachment of the exiting nerve roots and nerve roots at the lateral recesses.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is mild bilateral face hypertrophy and ligament flavum hypertrophy, loss of disk space height, a mild diffuse disk bulge present as well as disk desiccation. Although the neural foraminal are narrowed, within the neural foramina the exiting nerve roots are surrounded by fat. There are subacute endplate reactive changes anteriorly at this level.At L2-3 there is no significant compromise to spinal canal or neural foramina. There is loss of disk space height, a mild diffuse disk bulge present as well as disk desiccation. Although the neural foraminal are narrowed, within the neural foramina the exiting nerve roots are surrounded by fat. There are subacute endplate reactive changes anteriorly at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is loss of disk space height present as well as disk desiccation. There are Schmorl's nodes present at T12-L1
1.Please not that L5 is a transitional vertebra and partially sacralized.2.There are multilevel degenerative changes in the lumbar spine as detailed above which are worse at L4-5 where there is mild subluxation, mild spinal stenosis and nerve root encroachment of the exiting nerve roots and nerve roots at the lateral recesses.