58-year-old male with history of pain. Evaluate for herniated disc or spinal stenosis. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is slight straightening of the lumbar spine. Bone marrow signal is benign. The conus medullaris is normal in position terminating at the level of T12-L1. No abnormal enhancement is appreciated.Multilevel degenerative changes are seen, as described below:T12-L1: No significant disc disease. No spinal canal or neural foraminal stenosis.L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: There is a mild disc bulge with a slight right paracentral extrusion component without significant spinal canal stenosis. There is mild ligamentum flavum hypertrophy. No neuroforaminal stenosis.L3-L4: There is a mild disc bulge without significant spinal canal stenosis. There is mild ligamentum flavum and facet hypertrophy. There is mild neuroforaminal narrowing bilaterally.L4-L5: There is a significant disc bulge resulting in moderate spinal canal stenosis and crowding of the cauda equina. There is mild ligamentum flavum and facet hypertrophy. Facet joint effusions are present. There is moderate neuroforaminal narrowing bilaterally.L5-S1: There is mild disc bulge. Mild facet hypertrophy. No spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
Degenerative disc disease as above, worse at the L4-L5 level, with moderate spinal canal stenosis, facet joint effusions and neuroforaminal narrowing.