Lower extremity pain and weakness Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is grade 1 retrolisthesis of L5 on S1. Alignment of the lumbar spine is otherwise maintained. Bone marrow signal is benign. The conus medullaris is normal in position.There is developmental narrowing of the lumbar spinal canal with superimposed degenerative changes as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: There is disc desiccation, ligamentum flavum thickening, and moderate bilateral facet arthropathy. There is moderate to severe spinal canal stenosis including effacement of the lateral recesses. There is also moderate bilateral neural foraminal stenosis. L4-L5: There is disc desiccation with dorsal annular fissure and central protrusion component, which along with facet arthropathy and ligamentum flavum thickening contribute to severe spinal canal stenosis. There is also moderate bilateral neural foraminal stenosis.L5-S1: There is disc bulge with dorsal annular fissure and central protrusion component, bilateral facet arthropathy, and ligamentum flavum thickening. There is effacement of the lateral recesses and moderate central canal stenosis. There is also moderate right and mild to moderate left neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
1. Developmental narrowing of the lumbar spinal canal with superimposed degenerative changes contribute to severe spinal canal stenosis at the L4-L5 level and to a slightly lesser degree at the L5-S1 and L3-L4 levels.2. Moderate degree of neural foraminal stenoses at L3-L4, L4-L5, and L5-S1, as above.