 For the purposes of numbering of the lumbar levels, a partially sacralized L5 vertebral body is identified and the last discernible disc space is labeled L5-S1 disc. Grade 1 L4-L5 anterolisthesis. The lumbar spine is otherwise in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are maintained with mild disc desiccation throughout. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the L1 level. There is diffuse congenital narrowing of the lumbar spinal canal with superimposed prominence of the epidural fat and degenerative changes as described below:T12-L1: Minimal disc bulge and moderate bilateral facet degeneration, contributing to mild bilateral foraminal stenosis. No significant central spinal stenosis.L1-L2: Minimal disc bulge, thickening of the ligamentum flavum and moderate bilateral facet degeneration, contributing to mild bilateral foraminal stenosis. No significant central spinal stenosis.L2-L3: Mild disc bulge, thickening of the ligamentum flavum and moderate to severe bilateral facet degeneration, contributing to mild to moderate right and mild left foraminal stenosis. No significant central spinal stenosis.L3-L4: Disc bulge, thickening of the ligamentum flavum and moderate to severe bilateral facet degeneration, contributing to severe spinal canal stenosis and moderate bilateral foraminal stenosis. Findings are slightly progressed from prior study.L4-L5: Minimal anterolisthesis of L4 on L5. Disc bulge, thickening of the ligamentum flavum and moderate to severe bilateral facet degeneration, contributes to severe spinal canal stenosis and moderate bilateral foraminal stenosis. Findings are slightly progressed from prior study.L5-S1: No significant disc bulge, spinal canal or foraminal stenosis.There is partial ankylosis involving the sacroiliac joints right relatively greater than left. There are anterior bridging osteophytes.
1. There is congenital narrowing of the lumbar spinal canal with superimposed epidural lipomatosis and advanced degenerative changes. Degenerative changes are slightly progressed since 2005. There is severe L3-L4 and L4-L5 spinal canal stenosis and moderate bilateral neural foraminal stenosis, as detailed above.2. There is partial ankylosis involving the sacroiliac joints, right greater than left, which may be on a degenerative basis given associated anterior bridging osteophytes. Correlate however for any history of inflammatory spondyloarthropathy. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.