Low back pain and bilateral sciatica. Evaluate for canal stenosis. For the purpose of level numbering, there are 5 lumbar-type vertebrae with the last well-formed disc considered L5-S1. Alignment is notable for straightening which may reflect positioning. There is mild height and T2 signal loss at L4-5 with relative preservation at the other levels. The spinal canal is preserved. The tip of the conus medullaris is at the mid L1 level. The conus medullaris shows normal signal and shape.T12-L1, L1-L2, L2-L3 and L3-L4: No significant disc herniation. No spinal canal or foraminal stenosis.L4-L5: Minimal disc bulge and mild ligamenta flava thickening but no significant spinal canal stenosis. Moderate left facet arthropathy, along with disc bulge, result in mild left foraminal stenosis. The left facet arthropathy is associated with edema-like signal in the adjacent marrow including the left L5 pars interarticularis which is also associated with sclerosis. An underlying L5 pars defect would be difficult to reliably exclude.L5-S1: Minimal disc bulge but no spinal canal or foraminal stenosis.There are multiple small T1-hypointense, T2-hyperintense liver and kidney lesions that are not completely assessed though may represent cysts.
1.At L4-L5, there is mild degenerative disc and moderate left facet changes resulting in mild left neural foraminal stenosis but no spinal canal stenosis. 2.There is mild subjacent marrow edema-like signal involving the left L5 pars interarticularis associated with sclerosis. This may relate to the left L4-L5 facet arthropathy but an underlying pars interarticularis defect would be difficult to reliably exclude by MRI. CT scan of the lumbar spine would more reliably assess for spondylolysis. 3.There is no significant degenerative disease at the other levels.4.Small liver and kidney lesions are not completely assessed but may represent cysts.