52-year-old man with history of excruciating back pain and bilateral sciatica. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is minimal retrolisthesis of L5 on S1; otherwise the alignment is within normal limits. Bone marrow signal is slightly heterogeneous but benign. The L5/S1 disc is desiccated. 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: There is a minimal disc bulge. No spinal canal or neural foraminal stenosis.L3-L4: There is a minimal disc bulge. There is also mild prominence of the dorsal epidural fat and minimal narrowing of the spinal canal. Otherwise no significant spinal canal or neural foraminal stenosis. Mild facet arthropathy.L4-L5: There is a mild disc bulge with mild right and minimal left neural foraminal stenosis. There is moderate facet arthropathy. No spinal canal stenosis.L5-S1: There is a mild disc bulge with small central protrusion. There is mild right neural foraminal stenosis and mild to moderate left neural foraminal stenosis. No spinal canal stenosis.Paraspinous soft tissues are within normal limits.
1.Mild multilevel degenerative disease of the lumbar spine without high-grade spinal canal or high-grade neural foraminal stenosis at any level. There is mild right L4-5 and L5-S1 and mild to moderate left L5-S1 neural foraminal stenosis. Additional details as above.2. Moderate facet arthropathy at L4-5 which may also be contributing to patient's low back pain.