Lower back pain. Hx of pelvic pain and spastic pelvic floor syndrome Five lumbar type vertebral bodies are presumed to be present. There is evidence of mild scoliosis which can be better assessed with standing radiographs. There is also mild retrolisthesis of L1 on L2. Alignment is otherwise grossly maintained. Bone marrow signal is benign. The conus medullaris is normal in position. Moderate degenerative changes are present in the lumbar spine including loss of disc height at all levels and evidence of multilevel vacuum phenomena, which is worst at the L2-L3 level. There is associated edematous marrow signal change involving the superior endplate of L3. Vertebral body heights are grossly maintained.Individual levels as below:L1-L2: Mild retrolisthesis, disc bulge, and moderate bilateral facet arthropathy. There is no significant central canal stenosis. There is mild left neural foraminal stenosis. No significant right neural foraminal narrowing.L2-L3: Mild disc bulge, moderate bilateral facet arthropathy, and ligamentum flavum thickening. Minimal central canal narrowing. There is mild to moderate bilateral, left greater than right neural foraminal stenosis. L3-L4: There is a disc bulge, bilateral facet arthropathy, ligamentum flavum thickening, and prominence of the epidural fat. There is resulting mild to moderate central canal stenosis. There is mild to moderate left neural foraminal stenosis. No significant right neural foraminal narrowing.L4-L5: There is a disc bulge eccentric to the right as well as a small central protrusion. There is also ligamentum flavum thickening, bilateral facet arthropathy, and prominence of the epidural fat contributing to mild central canal stenosis. There is moderate right-sided neural foraminal stenosis. There is mild left neural foraminal stenosis.L5-S1: There is mild disc bulge, advanced bilateral facet arthropathy, as well as ligamentum flavum thickening. There is effacement of the lateral recesses, left worse than right. There is also mild central canal stenosis. There is moderate to severe left and mild to moderate right neural foraminal stenosis.
Moderate degenerative changes throughout the lumbar spine. There is mild to moderate central canal stenosis at the L3-L4 level and to a slightly lesser degree at additional levels as detailed above. There is also multilevel neural foraminal narrowing which is worst at the right L4-L5 and left L5-S1 levels. There is also advanced bilateral facet arthropathy throughout the lumbar spine which may be contributing to patient's back pain.