 The vertebral column alignment is within normal limits. The vertebral body heights are preserved. There is a mild degree of degenerative bone marrow signal alteration at the endplates of T11-T12, T12-L1, L4-L5, and L5-S1. The vertebral bone marrow signal is otherwise unremarkable. The distal spinal cord and conus medullaris display normal signal and morphology. The paravertebral soft tissues are unremarkable, aside from dependent edema. There is prominence of the epidural fat throughout the lumbar spine.L1-L2, L2-L3, and L3-L4: There are mild disc bulged, bilateral facet arthropathy, and ligament flavum thickening, without significant spinal canal or neural foraminal stenosis.L4-L5: There is a moderate disc bulge, bilateral facet arthropathy, and ligamentum flavum thickening. There is resultant mild spinal canal stenosis and moderate to severe neural foraminal narrowing bilaterally. There appears to be mild impingement on the exiting L4 nerve roots.L5-S1: There is a mild disc bulge, bilateral facet arthropathy and ligamentum flavum thickening. There is resultant mild spinal canal and moderate bilateral neural foraminal stenosis.There is marked left hydronephrosis and atrophy of bilateral kidneys.
1. Multilevel lumbar spondylosis, which is most pronounced at L4-L5, with resultant mild spinal canal and moderate to severe bilateral neural foraminal stenosis with impingement of bilateral exiting nerve roots.2. Epidural lipomatosis, which contributes to spinal canal narrowing, particularly int he lower lumbar and sacral regions.3. Marked left hydronephrosis and atrophy of bilateral kidneys.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.