43-year-old male with neurogenic claudication. Assess stenosis. There are defects in the bilateral pars interarticularis at L4 with minimal anterolisthesis of L4 on L5. The vertebral bone marrow signal is otherwise unremarkable. The imaged portions of the spinal cord and cauda equina are unremarkable. At L1-2, there is mild ligamentum flavum hypertrophy and facet hypertrophy with no significant spinal canal stenosis or neural foramen narrowing. At L2-3 there mild ligamentum flavum and facet hypertrophy without significant spinal canal stenosis or neuroforaminal narrowing. At L3-4, there is mild disc bulge and disc desiccation with annular fissuring, as well as mild ligamentum flavum and facet hypertrophy with minimal effacement of the ventral thecal sac and mild bilateral neuroforaminal narrowing. At L4-5, there is a disc bulge and disc desiccation with mild loss of disc height, ligamentum flavum hypertrophy, and facet hypertrophy, resulting in mild spinal canal stenosis as well as moderate to severe bilateral neural foramen narrowing. At L5-S1, there is a disc bulge, moderate facet and ligamentum flavum hypertrophy, resulting in mild spinal canal stenosis, as well as minimal to mild right and mild left neural foramen stenosis. The paravertebral soft tissues are unremarkable.
1. Multilevel degenerative spondylosis most prominent at L4-5, with mild central canal stenosis and moderate to severe bilateral neural foramen narrowing at this level.2. Bilateral pars interarticularis defects at L4, which are more conspicuous on the prior radiographs.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.