Right leg pain with intervertebral disc protrusion midline, low back pain Mild to moderate degenerative changes in the cervical spine are partially imaged including disc osteophyte complexes at the C4-C5, C5-C6, and C6-C7 levels.Thoracic: Vertebral body heights in the thoracic spine are normal. Alignment is normal. Bone marrow signal is benign with small scattered foci of T1 hyperintensity compatible with foci of fat or hemangiomas. There is no abnormal cord signal.Mild degenerative changes are seen in the thoracic spine including small right paracentral disc protrusion at the T3-T4 level which mildly deforms the ventral aspect of the cord. Posterior thecal sac is widely patent at this level without evidence of significant spinal canal stenosis. There is mild right-sided neural foraminal stenosis at T3-T4.Minimal disc protrusion is seen at T5-T6 and T6-T7. There is prominent ligamentum flavum thickening/calcification along the left T9-T10 and T10-T11 levels with minimal narrowing of the left posterior aspect of the thecal sac. There is moderate right T8-T9 neural foraminal stenosis. Spinal canal and neural foramina are otherwise patent.Lumbar: Please note for the purposes of numbering there are 5 lumbar type vertebral bodies and a lumbarized transitional segment labeled L6 for the purposes of this study. As such the most inferior well-defined disc space is labeled L6-S1. Vertebral body heights are within normal limits. There is minimal anterolisthesis of L5 on L6. Alignment is otherwise within normal limits. Bone marrow signal is slightly heterogeneous without discrete destructive osseous lesion. Hemangioma involving the L4 vertebral body incidentally noted. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:T12-L1: Mild disc bulge with minimal central protrusion component partially effacing the ventral thecal sac. No significant neural foraminal stenosis.L1-L2: Small central disc protrusion, without significant spinal canal or neural foraminal stenosis. L2-L3: Central and paracentral disc protrusion, ligamentum flavum thickening, and facet arthropathy result in moderate central spinal canal stenosis at this level. There is effacement of the lateral recesses. There is mild bilateral neural foraminal stenosis.L3-L4: Mild disc bulge, ligamentum flavum thickening, and facet arthropathy without significant spinal canal stenosis. There is mild bilateral neural foraminal stenosis.L4-L5: Mild disc bulge, facet arthropathy, and ligamentum flavum thickening without significant spinal canal stenosis. There is mild to moderate right and mild left neural foraminal stenosis.L5-L6: Advanced bilateral facet arthropathy and minimal anterolisthesis. There is disc uncovering and mild bulge. There is effacement of the lateral recesses, right worse in left. There is moderate central canal stenosis. There is mild to moderate neural foraminal stenosis bilaterally.There is subluxation and mild fragmentation involving the facet joints as well as possible pars defect, which can be better assessed with CT. L6-S1: No significant disc disease. No spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits. Right renal cyst partially visualized.
1. Mild degenerative changes in the thoracic spine without cord signal abnormality or high-grade spinal canal stenosis at any level. There is mild right T3-T4 and moderate right T8-T9 neural foraminal stenosis. Small disc protrusion at the T3-T4 level and ligamentum flavum thickening/calcification at the T9-T10 and T10-T11 levels minimally narrow the thecal sac without significant spinal canal stenosis.2. Please note variant anatomy with transitional lumbosacral junction and numbering (L1-L6) as detailed above. There are multilevel degenerative changes in the lumbar spine with moderate central spinal canal and lateral recess stenosis at the L2-L3 and L5-L6 levels. There is advanced facet arthropathy at L5-L6 with minimal anterolisthesis. Relatively mild neural foraminal stenosis at multiple levels as detailed above.3. Degenerative changes in the cervical spine are partially imaged.