 There appears to be lumbarization of S1 based on the location of the last rib and the the lumbar ligament. For the purposes of this exam, the last fully formed disc space will be termed of S1-S2. There is an apex rightward lumbar spinal curvature. The vertebral body heights are preserved. With the exception of endplate degenerative change and presumed hemangiomas, the vertebral bone marrow signal is unremarkable. The imaged spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.L1-L2: Unremarkable.L2-L3: There is mild disc desiccation without significant bulge, herniation, spinal canal, or neural foramen stenosis.L3-L4: There is mild disc desiccation and mild disc bulge as well as mild facet arthropathy and ligamentum flavum thickening without significant spinal canal or neural foramen stenosis.L4-L5: There is disc desiccation and mild disc bulge as well as endplate degenerative change, facet arthropathy, and ligamentum flavum thickening. These findings result in moderate spinal canal stenosis as well as moderate bilateral neural foramen stenosis.L5-S1: There are postoperative findings related to prior bilateral laminotomies, left facetectomy, and microdiscectomy. There is disc desiccation, loss of disc height, endplate degenerative change, and tissue posterior and contiguous with the disc that may represent disc material or granulation tissue. There is also similar signal intensity tissue along the left posterior lateral aspect of the spinal canal. There is bilateral moderate-severe neural foraminal stenosis and mild-moderate spinal canal stenosis.S1-S2: There is disc desiccation, endplate degenerative change, and mild disc bulge with a superimposed mild central disc herniation. These findings result in moderate left neural foramen stenosis.
1.Probable transitional anatomy with lumbarization of S1 as detailed above. If surgery is to be contemplated, correlation with imaging of the entire spine is recommended.2.Postoperative findings at L5-S1 with nonspecific tissue anteriorly contiguous of the disc and along the left ventrolateral epidural space, with mild spinal canal stenosis and bilateral moderate neural foramen stenosis. This tissue could be further characterized with postcontrast sequences.3.Additional lumbar spine degenerative changes as detailed above resulting in at most moderate spinal canal stenosis and moderate foraminal stenosis.