Back pain, evaluate spinal stenosis. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild rightward translation of L2 on L3, leftward translation of L4 on L5, and overall levoscoliosis of the lumbar spine with apex at the L3-L4 level. There is severe loss of disc height involving the right aspect of the L3-L4 level.Bone marrow signal is benign with degenerative endplate changes, relatively more prominent involving the left aspect of the L4-L5 endplates. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Rightward translation of L2 on L3 and moderate disc height loss and disc bulge which is eccentric to the left. There is also mild bilateral facet arthropathy. There is no significant central spinal canal stenosis. There is however mild to moderate left neural foraminal stenosis. Right neural foramen is patent.L3-L4: Severe loss of disc height on the right with subchondral cysts, endplate irregularity, mild disc bulge, and vacuum phenomena. There is also advanced right-sided facet arthropathy with mild distention of the facet joint. There is mild central spinal canal stenosis. There is moderate to severe right-sided neural foraminal stenosis. Left neural foramen is patent.L4-L5: Mild leftward translation of L4 and L5, disc bulge with vacuum phenomena, ligamentum flavum thickening, and moderate to severe bilateral facet arthropathy. There is also a small central disc extrusion. There is partial effacement of the left lateral recess without significant central spinal canal stenosis. There is moderate to severe left and moderate right neural foraminal stenosis.L5-S1: Mild disc bulge with vacuum disc phenomena and significant loss of height involving the left aspect of the disc space. There is a prominent left lateral osteophyte. Moderate bilateral facet arthropathy. There is no significant central spinal canal stenosis. There is moderate to severe left and mild right neural foraminal stenosis.
1. Degenerative changes throughout the lumbar spine with malalignment including levoscoliosis with apex at the L3-L4 level. 2. There is mild central spinal canal stenosis at L3-L4. No high-grade spinal canal stenosis is present at any level.3. Neural foraminal stenoses are most significant at the right L3-L4 and left L2-L3, L4-L5, and L5-S1 levels. Additional details as above.