Neurofibromatosis type II variant. Severe low back pain radiating to the right foot. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild loss of lumbar lordosis. There is mild retrolisthesis of L2 on L3 and L3 on L4 as well as L5 on S1. There is severe loss of disc space at the L4-L5 level with fatty endplate marrow signal changes similar to prior study from 5/17/2008. Bone marrow signal is benign. The conus medullaris is normal in position.There are tiny nodular foci of enhancement along the surface of the visualized distal thoracic cord as well as a focus involving the cauda equina nerve roots at the right L4 level (sagittal series 13 image 9 and axial series 12, image 33). There is no clear evidence of enlargement compared to prior MRI from 10/6/2014 as well as 5/17/2008.Multilevel degenerative changes are seen in the lumbar spine which are not significantly changed. Individual levels as described below:L1-L2: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L2-L3: Minimal disc bulge. No spinal canal or neural foraminal stenosis. Mild facet arthropathy with small joint effusions.L3-L4: Minimal disc bulge. No spinal canal or neural foraminal stenosis. There is moderate bilateral facet arthropathy.L4-L5: Mild disc bulge with small central protrusion. No significant spinal canal stenosis. Minimal neural foraminal narrowing without evidence of impingement. Mild bilateral facet arthropathy.L5-S1: Mild disc bulge with small protrusion. There is moderate left worse than right facet arthropathy. No significant spinal canal stenosis or neural foraminal narrowing.Paraspinous soft tissues are within normal limits.
1. Tiny enhancing nodules are suspected involving the surface of the lower thoracic cord as well as at the L4 level of the spinal canal slightly to the right of the midline. These may represent tiny schwannomas. No clear evidence of enlargement when compared to prior MRI from 2014 as well as 2008.2. Multilevel degenerative changes in the lumbar spine without significant spinal canal stenosis or nerve root impingement to explain provided history. There is multilevel facet arthropathy which may be contributing to patient's low back pain.