65-year-old male patient with possible right lower extremity radiculopathy. Evaluate for degenerative changes/lumbar stenosis. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are grossly preserved. Alignment is anatomic except for a grade I anterolisthesis of L4 on L5. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes, including multilevel disc dessication, are seen, as described below:L1-L2: No significant disc disease. There is mild bilateral neural foraminal stenosis. No spinal canal stenosis.L2-L3: Minimal disc bulge and ligamentum flavum hypertrophy. There is moderate left and mild to moderate right neural foraminal stenosis and mild facet hypertrophy. No spinal canal stenosis.L3-L4: There is a disc bulge, ligamentum flavum, and facet hypertrophy causing moderate to severe right and moderate left neural foraminal stenosis. No spinal canal stenosis.L4-L5: There is grade 1 anterolisthesis of L4 on L5 and disc uncovering. There is ligamentum flavum hypertrophy and advanced facet hypertrophy. There is moderate spinal canal stenosis. There is severe left and moderate to severe right neural foraminal stenosis. L5-S1: There is mild disc bulge without canal stenosis. There is bilateral ligamentum flavum and facet hypertrophy with mild right and moderate left neural foraminal stenosis. No spinal canal stenosis. A subcentimeter cystic structure posterior to the right L5/S1 facet joint likely represents a small synovial cyst.Paraspinous soft tissues are within normal limits.
1. Multilevel degenerative changes of the lumbar spine, worst at the L4/L5 level with moderate spinal canal stenosis. There is also moderate to severe multilevel neural foraminal narrowing as detailed above.2. Advanced facet arthropathy at L4-L5. There is grade 1 anterolisthesis of L4 on L5 which is likely on a degenerative basis. 