Right lower extremity radiculopathy with lumbar spondylolisthesis. Five lumbar type vertebral bodies are present. There is loss of lumbar lordosis and dextroscoliosis with apex at the L3-L4 level. There is 1 cm right lateral subluxation of L3 on L4. No compression fractures. Advanced degenerative changes are seen at the L3-L4 and L4-L5 levels with severe loss of intravertebral disk height and associated endplate changes. No suspicious osseous lesions are seen. The conus medullaris is normal in position at the L1-L2 level.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Trace disk bulge, asymmetric to the right, with minimal right neural foraminal narrowing. There is also mild left neural foraminal stenosis related to facet arthropathy. No spinal canal stenosis.L3-L4: Advanced degenerative changes with right lateral subluxation, loss of disk height, and type II Modic endplate signal changes. There is disk bulge which in combination with prominence of the epidural fat and facet arthropathy results in mild to moderate spinal canal stenosis. There is effacement of the lateral recesses, left greater than right. There is mild right and mild to moderate left neural foramina stenosis.L4-L5: Advanced degenerative changes with loss of disk height and Modic type 1/edematous endplate marrow signal changes. There is disk bulge with effacement of the lateral recesses without significant central spinal canal stenosis. There is severe right neural foramina stenosis, and mild left neural foramina stenosis. L5-S1: Small central protrusion. No spinal canal or neural foraminal stenosis.There is facet arthropathy throughout the lumbar spine. Small left renal cysts incidentally noted.
1. Advanced degenerative changes in the lumbar spine at L3-L4 and L4-L5 as detailed above with loss of lumbar lordosis and 1 cm right lateral subluxation of L3 on L4. Multilevel facet arthropathy.2. Severe right L4-L5 neural foramina stenosis with suspected impingement of the exiting right L4 nerve root. Stenosis at additional levels as described above.3. Mild to moderate spinal canal stenosis at L3-L4 related to combination of disk bulge and epidural fat.