53 year-old female with chronic low back pain, sciatica, and morbid obesity. Evaluate for spinal lesion. Sagittal T1 and postcontrast images are degraded by motion artifact. Five lumbar type vertebral bodies are presumed to be present which are appropriate in height. There is minimal 4 mm anterolisthesis of L4 on L5. The conus medullaris on sagittal imaging is grossly intact.At L1-2 there is disk desiccation, loss of disk height, and enhancing central annular fissure. No significant compromise to spinal canal or neural foramina is present.At L2-3 there is trace disk bulge, mild ligamentum flavum hypertrophy and facet hypertrophy. There is no significant central canal or neuroforaminal stenosis.At L3-4 there is mild disk bulge with prominent proximal left foraminal component, ligamentum flavum hypertrophy, and facet arthropathy. Mild to moderate central canal stenosis as well as mild to moderate left neuroforaminal stenosis are present.At L4-5 there is uncovering of the disk, superimposed disk bulge and severe facet hypertrophy. Mild central canal stenosis as well as mild left neuroforaminal stenosis are present.At L5-S1 there is right paracentral to far right lateral enhancing annular fissure, mild disk desiccation, and severe facet hypertrophy, right greater than left. There is moderate right neuroforaminal stenosis.
Multilevel degenerative changes. Most prominent changes include mild to moderate central canal stenosis at L3-4 as well as moderate right neuroforaminal stenosis at L5-1, and to a lesser degree at other levels as detailed above.