Lumbar back pain with right-sided radiculopathy, evaluate for spinal stenosis, spondylolisthesis or other pathology. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is evidence of grade 1 anterolisthesis of L3 over L4. Bone marrow signal is benign. The conus medullaris is normal in position, terminating at upper L2. There is multilevel mild to moderate disc space narrowing which is worst at L3-L4.Multilevel moderate to severe degenerative changes are seen, as described below:T12-L1: There is ligamentum flavum thickening and facet arthropathy. No significant disc disease, neuroforaminal narrowing or spinal canal stenosis.L1-L2: There is facet arthropathy. No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: There is disc bulge eccentric to the left, facet arthropathy with resultant narrowing of bilateral lateral recesses, including moderate bilateral neural foraminal narrowing. There is moderate to severe spinal canal stenosis. L3-L4: There is facet arthropathy, disc bulge eccentric to the right with resultant severe spinal canal stenosis. There is mild to moderate bilateral neural foraminal narrowing. L4-L5: There is facet arthropathy, annular fissure and disc bulge eccentric to the with right, reflecting mild spinal canal stenosis. There is moderate to severe right and mild left neural foraminal narrowing. There is dorsal epidural lipomatosis at this level. L5-S1: There is facet arthropathy left worse than right, disc extrusion which extends cranially up to 8 mm with resultant mild mass effect on the central and left lateral aspect of the thecal sac. There is narrowing of the lateral recess and mild narrowing of left neural foramen. There is no spinal canal stenosis.Paraspinous soft tissues are within normal limits.
1. Multilevel advanced degenerative spondylotic changes worst at L3-L4, where there is severe spinal canal stenosis. Moderate to severe spinal canal stenosis at L2-L3 is also noted.2. At L5-S1 there is a disc extrusion with mild mass effect on the thecal sac. 3. At L4-L5, there is moderate to severe neuroforaminal narrowing.