Radicular pain, evaluate for possible nerve impingement in the lumbar spine Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign with T1 hyperintense lesion at L4 consistent with a hemangioma. Fatty endplate marrow signal changes are noted at L5-S1 on a degenerative basis. The conus medullaris is normal in position at the L1-L2 level.Multilevel degenerative changes are seen with disc desiccation throughout the lumbar spine. There is significant loss of disc height at L5-S1 and to a milder degree at the remaining levels. Individual levels as below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis. Bilateral facet arthropathy.L2-L3: Minimal disc bulge. No spinal canal stenosis. Minimal bilateral foraminal narrowing. Bilateral facet arthropathy.L3-L4: Mild disc bulge and facet arthropathy without spinal canal stenosis. There is mild right and moderate left neural foraminal stenosis. L4-L5: Mild disc bulge and moderate bilateral facet arthropathy without significant spinal canal stenosis. There is mild to moderate bilateral neural foraminal narrowing.L5-S1: Mild disc bulge and bilateral facet arthropathy without significant spinal canal stenosis. There is no significant right neural foraminal narrowing. There is moderate left neural foraminal stenosis. Paraspinous soft tissues are within normal limits. Small right renal cyst incidentally noted.
1. Degenerative changes in the lumbar spine without significant spinal canal stenosis at any level. There is up to moderate left L3-L4 and left L5-S1 neural foraminal stenosis, which may be producing left L3 or L5 radiculopathy. Individual levels as above.2. Multilevel facet arthropathy, relatively worse at the L4-L5 and L5-S1 levels, and may be contributing to patient's low back pain.