 There is levocurvature to the lumbar spine centered at L4 and L5. There is osseous fusion at L4 and L5. Otherwise, the vertebral body heights are preserved. There is multilevel disc desiccation as well as trace fluid in the intervertebral disc spaces, with mild to moderate disc height loss at several levels. There are scattered T1 and T2 hyperintense lesions throughout the spine which may represent fat and/or hemangiomas. The vertebral bone marrow signal is otherwise unremarkable. There are advanced degenerative changes in the lower thoracic and lumbar spine. There is 5 mm of retrolisthesis of T12 over L1, which in combination with facet joint arthropathy results in severe spinal canal stenosis with compression of the spinal cord and bilateral neural foraminal narrowing at this level. There is significant spinal canal stenosis. At L1-L2, there is 10 mm of right lateral listhesis, bilateral facet arthropathy, and a disc bulge that result in effacement of the lateral recess bilaterally right more than left, with encroachment on the right exiting nerve root within the neural foramen and moderate spinal canal stenosis. At L2-3, there is disc bulge, facet arthropathy, and ligamentum flavum thickening with resultant moderate bilateral neural foraminal narrowing and mild-to-moderate spinal canal stenosis. At L3-L4, there is loss of disc height, disc bulge, facet arthropathy, ligamentum flavum thickening, and epidural lipomatosis, with resultant moderate bilateral neural foramina narrowing and mild-to-moderate spinal canal narrowing. At L4-5, there is loss of disc height, with osseous bridging across the left side of the disc space. There is bilateral facet hypertrophy with resultant mild right and mild-to-moderate left neuroforaminal narrowing, and severe spinal canal stenosis with compression of the cauda equina nerve roots. At L5-S1, there is loss of disc height, bilateral facet hypertrophy, with minimal spinal canal and neural foramen stenosis. There is a large gallstone. Otherwise, the paravertebral soft tissues are unremarkable.
1. Extensive multilevel degenerative changes in the lumbar spine, retrolisthesis of T12 over L1, and prominent posterior epidural lipomatosis at L4 and L5, that result in particularly severe spinal canal stenosis and spinal cord compression at T12-L2 and severe spinal canal stenosis at L4-5 with compression of the nerve roots. Variable degrees of neural foraminal narrowing are present at multiple levels as well.2. Levoscoliosis of the lumbar spine.3. Large gallstone.