Right sciatica Examination is limited by motion artifact. Numbering is performed as per recent radiograph with the last rib- bearing vertebra labeled T12. L5 demonstrates a transitional morphology with advanced hypertrophic degenerative changes at the right L5 transverse process-sacral articulation.Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of of L4 on L5 and mild dextrocurvature of the lumbar spine as seen on recent radiograph. Alignment is otherwise maintained. There is T1 hypointense and T2 hyperintense lesion involving the T11 vertebral body which may represent an atypical hemangioma but is indeterminate. Bone marrow signal is otherwise benign. There is advanced facet arthropathy at the bilateral L4-5 level and right L5-S1 articulation.The conus medullaris is within normal limits terminating at the mid L2 level. There is a filum lipoma measuring up to 8 x 7 mm in the axial dimension and extends from the upper L3 to the sacrum. Multilevel degenerative changes are seen, 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: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: There is disk desiccation, disk uncovering, and mild bulge. There is moderate right neural foramina stenosis which may be impinging on the exiting right L4 nerve root. There is minimal left neural foramina narrowing. Advanced bilateral facet arthropathy and grade 1 retrolisthesis. No spinal canal stenosis.L5-S1: Transitional anatomy as above. No spinal canal stenosis or neural foramina stenosis. There is contact of the right L5 nerve root with osteophyte at the right L5-sacral articulation. Paraspinous soft tissues are within normal limits.
1. Transitional anatomy at the lumbosacral junction as detailed above. Advanced hypertrophic degenerative changes are seen at the right L5 transverse process-sacral articulation.2. Conus is at the mid L2 level which is within normal limits with this numbering scheme. There is a lipoma involving the filum terminale. Correlate with clinical findings for possibility of tethered cord. 3. Grade 1 L4-5 anterolisthesis with advanced bilateral facet arthropathy at this level. There is moderate right L4-5 neural foraminal stenosis which maybe impinging on the exiting right L4 nerve root. There is also contact of the right L5 nerve root with osteophyte at the right L5-sacral articulation. 4. Nonspecific vertebral body lesion at T11, possibly an atypical hemangioma. CT might be helpful to identify striations which can be seen with a hemangioma. 