Reason: pain History: pain Five lumbar type vertebral bodies are presumed to be present. There is grade 1 anterolisthesis of L4 on L5. There is slight straightening of the normal lumbar lordosis. The vertebral body heights are well-maintained. There is multilevel loss of intervertebral disc space with endplate degeneration particularly at L2-3 and L5-S1. The conus medullaris on sagittal imaging is intact.There is a combination of disc disease and facet hypertrophy resulting in narrowing of the bilateral neuroforamina at T10-11 and T11-12.T12-L1: There is mild facet hypertrophy. No significant compromise to spinal canal or neural foramina.L1-L2: There is mild facet hypertrophy. No significant compromise to spinal canal or neural foramina.L2-L3: There is diffuse annular disc bulge with facet and ligamentum flavum hypertrophy resulting in moderate narrowing of the spinal canal, mild narrowing of the left neuroforamen and mild to moderate narrowing of the right neuroforamen. There is also mild bilateral lateral recess stenosis.L3-L4: There is diffuse annular disc bulge with facet and ligamentum flavum hypertrophy resulting in moderate narrowing of the spinal canal and moderate narrowing of the both neuroforamina, right greater than left. There is also moderate bilateral lateral recess stenosis.L4-5: There is diffuse annular disc bulge with facet and ligamentum flavum hypertrophy resulting in severe narrowing of the spinal canal, moderate narrowing of the right neuroforamen and moderate to severe narrowing of the left neuroforamen. There is also severe bilateral lateral recess stenosis.L5-S1: There is asymmetric left annular disc bulge with bilateral lateral osteophytes in addition to facet and ligamentum flavum hypertrophy resulting in mild narrowing of the spinal canal and moderate narrowing of both neuroforamina. Additionally, the bilateral S1 nerve root origins are flattened and compressed.
1.Multilevel spondylotic changes affect the lumbar spine, most pronounced at L3-4, L4-5 and L5-S1 where there is central stenosis, lateral recess stenosis, and neural foraminal stenosis, as detailed above.2.There is a combination of disc disease and facet hypertrophy resulting in narrowing of the bilateral neuroforamina at T10-11 and T11-12. If the patient has symptoms localized to thoracic spine, a dedicated MRI of the thoracic spine may be of benefit.