Persistent left sciatica which has been increasing. Known spinal DJD. There is reversal of the lordosis with 3 mm of grade 1 retrolisthesis of L3 on L4 and 4 mm of retrolisthesis of L5 on S1. There is also levoscoliosis and moderate to severe degenerative disc narrowing at multiple levels. The bone marrow demonstrates a heterogeneous signal which is nonspecific. The spinal cord displays normal signal and morphology and terminates at the L1 level. The paravertebral soft tissues are unremarkable. T10-T11: On sagittal views, there is a small diffuse disc bulge but no significant central canal or neuroforaminal stenosis.T11-T12: A disc bulge is noted with facet hypertrophy and ligamentum flavum thickening. There is mild to moderate bilateral neural foraminal and mild to moderate central canal stenosis.T12-L1: There is a disc bulge with moderate facet hypertrophy and ligamentum flavum thickening which causes moderate bilateral neural foraminal stenosis and at most mild to moderate central canal stenosis.L1-L2: There is a disc bulge and left greater than right facet hypertrophy and ligamentum flavum thickening which causes mild right and moderate to severe left neuroforaminal stenosis and moderate central canal stenosis.L2-L3: There is a disc bulge with severe facet hypertrophy and ligamentum flavum thickening which causes minimal right and moderate to severe left neural foraminal stenosis as well as moderate central canal stenosis.L3-L4: A shallow left foraminal/far lateral disc protrusion is superimposed on the uncovering of the disc. There is also severe facet hypertrophy, right greater than left, and ligamentum flavum thickening which causes severe right and moderate to severe left neural foraminal stenosis. This also causes moderate to severe central canal stenosis with effacement of the right lateral recess.L4-5: A disc bulge is seen at this level with severe facet hypertrophy and ligamentum flavum thickening with moderate to severe bilateral neural foraminal stenosis and mild to moderate central canal stenosis.L5-S1: A disc bulge is noted with a superimposed left to right paracentral shallow disc protrusion with facet and ligamentum flavum hypertrophy. This causes left greater than right neural foraminal stenosis with effacement of the left lateral recess. There is also moderate central canal stenosis.A small rounded T2 hyperintense lesion is noted within the upper pole of the right kidney which is nonspecific but statistically most likely represents a renal cyst.
1.Diffuse moderate to severe degenerative disease of the lower thoracic and lumbar spine with at most moderate-severe central spinal canal stenosis at L3-4 and multilevel neural foraminal stenosis, and multiple levels of moderate-severe to severe foraminal narrowing as detailed above.2.There is also lumbar levoscoliosis and degenerative grade 1 retrolisthesis of L3 on L4 and L5 on S1.