Female 51 years old with radiating left lower extremity pain x6 months, evaluate for etiology of radiculopathy Minimal rightward curvature of the lumbar spine on coronal images. Minimal retrolisthesis of L4 on L5. Vertebral body heights are preserved. Mild degenerative endplate changes with Schmorl nodes noted within the inferior endplates of L4 and T11. Scattered vertebral body hemangiomas noted. No pathological marrow abnormality noted. Minimal diffuse loss of disc height with signal desiccation most prominent at T11-12 and L4-5. The distal spinal cord and conus medullaris are unremarkable and terminate at the T12-L1 level. Incidental circumaortic left renal vein, otherwise the paravertebral soft tissues are unremarkable. T11-12: No significant central or foraminal stenosis noted on sagittal images.T12-L2: Minimal bilateral facet arthropathy without significant central or foraminal stenosis.L2-L3: Mild bilateral facet arthropathy and ligamentum flavum hypertrophy without significant central or foraminal stenosis.L3-4: Moderate bilateral facet arthropathy as well as ligamentum flavum hypertrophy without significant central or foraminal stenosis.L4-L5: Central and paracentral disc extrusion superimposed on disc bulging with partial articular encroachment, which abuts the descending L5 nerve roots. Moderate bilateral facet arthropathy and ligamentum flavum hypertrophy. Moderate right and severe left foraminal stenosis as well as moderate central stenosis.L5-S1: No significant central or foraminal stenosis.
Spondylosis as described above with L4-5 central and paracentral disc extrusion, which abuts the descending L5 nerve roots bilaterally and indents the thecal sac, and causes moderate right and severe left foraminal stenosis as well as moderate central stenosis. Correlate clinically for bilateral L5 radiculopathy.