Low back pain with radiation into left thigh, also history of metastatic breast cancer, possible spinal stenosis, on tamoxifen. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. There is mild heterogeneity of the bone marrow which is nonspecific. Endplate marrow signal changes are noted at L4-L5 and L5-S1 which are on a degenerative basis. No suspicious focal lesions are appreciated. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: Minimal disk bulge. No spinal canal or neural foraminal stenosis.L2-L3: Minimal disk bulge with mild right foraminal disk protrusion. Minimal narrowing of the inferior aspect of the right neural foramen. Otherwise, no significant spinal canal or left neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: There is disk desiccation with loss of height with mild diffuse disk bulge. There is also ligamentum flavum thickening and mild facet arthropathy which result in minimal narrowing of the spinal canal. There is mild to moderate left neural foraminal narrowing. No right neural foraminal stenosis.L5-S1: There is disk desiccation with loss of height and mild bulge. There is no significant spinal canal stenosis. There is mild to moderate right and mild left neural foraminal narrowing. There is mild multilevel facet arthropathy. Paraspinous soft tissues are within normal limits. Small bilateral renal cysts.
1. No compression fractures or suspicious lesions within the lumbar spine to suggest metastatic disease. Postcontrast study would be more sensitive for small lesions and can be considered if clinically indicated.2. Mild multilevel degenerative changes as detailed above. There is minimal narrowing of the spinal canal at L4-L5, otherwise no significant spinal canal stenosis at any level.3. There is mild to moderate left neural foraminal stenosis at L4-L5 related to disk bulge and facet arthropathy. There is contact of the exiting left L4 nerve root.