Back pain, unable to walk secondary to pain and weakness 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. The conus medullaris is normal in position at the lower L1 level.Multilevel degenerative changes are seen, as described below:L1-L2: There is a central and right paracentral disc extrusion with T2 hypointensity. There is adjacent epidural soft tissue density which extends from the lower L1 level to the mid L2 level which is nonspecific but suspected to represent epidural hematoma and/or extruded disc material. There is severe spinal canal stenosis at this level. No significant neural foraminal narrowing.L2-L3: Diffuse disc bulge eccentric to the left without significant spinal canal stenosis. Mild right and moderate left neural foraminal stenosis.L3-L4: Diffuse disc bulge, ligamentum flavum thickening and facet arthropathy resulting in moderate to severe spinal canal stenosis. There is mild right and moderate to severe left neural foraminal stenosis. Annular fissure is noted at the left foraminal and extraforaminal level.L4-L5: Diffuse disc bulge, ligamentum flavum thickening, and facet arthropathy resulting in moderate spinal canal stenosis. There is mild to moderate bilateral neural foraminal stenosis.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
Multilevel degenerative changes in the lumbar spine with moderate to severe spinal canal stenosis at the L1-L2, L3-L4, and L4-L5 levels. There is a disc extrusion at the L1-L2 level with adjacent epidural soft tissue extending from the lower L1 to the mid L2 levels which may represent epidural hematoma and/or extruded disc material. Other neoplastic/inflammatory etiologies for epidural tissue while possible seem less likely. There is severe spinal canal stenosis at this level.Moderate to severe left L3-L4 neural foraminal stenosis is seen which may be impinging on the left L3 nerve root. Lesser degrees of neural foraminal narrowing as detailed above.