69-year-old male with pain in thigh when walking. Assess for lumbar stenosis/radiculopathy There is grade 1 anterolisthesis of L4 on L5. Alignment of the lumbar spine is otherwise maintained. Small Schmorl's nodes are noted at the endplates at multiple levels. There are mild anterior wedging of T11 and T12 which may be physiologic. Vertebral body heights are otherwise maintained. There is no suspicious marrow signal. Conus is in normal position and demonstrates normal signal. There are multilevel degenerative changes, individual levels as below:At T11-T12, there is no significant narrowing of the spinal canal or neural foraminal narrowing. At T12-L1, there is no significant narrowing of the spinal canal or neural foraminal narrowing.At L1-L2, there is mild disc bulge, ligamentum flavum thickening, and mild facet arthropathy resulting in mild spinal canal stenosis. No significant neural foraminal stenosis. At L2-L3, there is no significant narrowing of the spinal canal or neural foraminal narrowing.At L3-L4, there is a mild spinal canal stenosis related to mild disc bulge, facet arthropathy, and prominence of the epidural fat. There is no significant right neural foraminal narrowing. There is mild left neural foraminal narrowing.At L4-L5, there is grade 1 anterolisthesis with disc uncovering and mild bulge, advanced bilateral facet arthropathy, and ligamentum flavum thickening resulting in moderate spinal canal stenosis. There is mild bilateral neural foraminal stenosis.At L5-S1, there is a minimal disc bulge with no significant narrowing of the spinal canal or neural foraminal narrowing.There are bilateral T2 hyperintense lesions involving the kidneys likely representing cysts.
Moderate degenerative changes in the lumbar spine, worst at the L4-L5 level where there is advanced facet arthropathy, grade 1 anterolisthesis, and disc bulge with resulting moderate spinal canal stenosis. Relatively mild neural foraminal narrowing at L4-L5 bilaterally and on the left at L3-L4.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.