 For the purposes of numbering, the last rib bearing vertebra is termed T12. There is suggestion of transitional lumbosacral junction, with right aspect of L5 appearing to articulate with the sacrum, and can be better assessed with CT if surgery is contemplated. There is a lumbar dextroscoliosis. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable. The imaged spinal cord displays normal signal and morphology with the conus terminating at L1-L2. There is a subcentimeter left renal cyst. The paravertebral soft tissues are unremarkable.Degenerative changes, with individual levels as below.T12-L1: There is mild facet arthropathy and ligamentum flavum thickening without significant disc disease, spinal canal, or neural foraminal narrowing.L1-L2: There is minimal disc desiccation, mild facet arthropathy and ligamentum flavum thickening without significant spinal canal or neural foraminal narrowing.L2-L3: There is mild disc desiccation and mild asymmetric rightward disc bulge with mild facet arthropathy and ligamentum flavum thickening. There is no significant spinal canal or neural foraminal narrowing.L3-L4: There is minimal right lateral subluxation of L3 on L4. There is disc desiccation and a mild disc bulge as well as facet arthropathy and ligamentum flavum thickening. These findings result in mild spinal canal stenosis and minimal bilateral foramina narrowing. L4-L5: There is disc desiccation, mild loss of disc height, and mild disc bulge as well as facet arthropathy and ligamentum flavum thickening. In addition, there is a 7 x 12 mm T2 hyperintense structure in the right aspect of the spinal canal adjacent to the right facet joint that is most compatible with a synovial cyst. These findings result in moderate to severe spinal canal stenosis involving the right aspect of the thecal sac. There is moderate right and mild to moderate left neural foramina stenosis. L5-S1: There is grade 1 anterolisthesis of L5 on S1. There is disc desiccation, loss of disc height, mild disc bulge asymmetric to the right, and facet arthropathy. These findings result in severe right and mild left neural foraminal stenosis.
1.Lumbar dextroscoliosis and grade 1 anterolisthesis at L5-S1. Please see note regarding transitional anatomy above. 2.Advanced degenerative changes at the L4-L5 and L5-S1 levels. There is a right synovial cyst at L4-L5 which results in moderate to severe spinal canal stenosis involving the right aspect of the thecal sac (with possible impingement of traversing right L5 and sacral nerve roots). There is also moderate right neural foraminal narrowing at L4-L5 and severe right neural foraminal narrowing at L5-S1.3.Advanced facet arthropathy in the lower lumbar spine.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.