54-year-old male with history of laryngeal cancer and low back pain. Examination is motion degraded. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is moderate loss of disc height at L5-S1. Alignment is within normal limits. Bone marrow is heterogenous and nonspecific without destructive suspicious lesions. There is signal abnormality along the inferior endplate of L5 on a degenerative basis. The conus medullaris is normal in position terminating at the level of L1. The paraspinous soft tissues are within normal limits.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No significant spinal canal or neuroforaminal stenosis.L2-L3: No significant disc disease. No significant spinal canal or neuroforaminal stenosis.L3-L4: Mild disc bulge. Moderate facet hypertrophy with inflammatory changes surrounding the right facet joint. No significant spinal canal or neuroforaminal stenosis.L4-L5: Right paracentral disc protrusion with effacement of the right lateral recess contacting the descending right L5 nerve root. Moderate facet hypertrophy. No significant central spinal canal or neuroforaminal stenosis.L5-S1: There is moderate loss of disc height with central and left foraminal disc protrusions resulting in mild right and moderate left neuroforaminal stenosis. Moderate facet hypertrophy. No significant central spinal canal stenosis.
1. Multilevel degenerative disease as above worst at L4-5 and L5-S1. There is up to moderate left L5-S1 neuroforaminal narrowing which may be impinging on the left L5 nerve root. Additional levels as above.2. Heterogenous bone marrow which is nonspecific. No suspicious focal lesions are seen to suggest metastatic disease. 3. Facet arthropathy at L3-4, L4-5, and L5-S1 with mild inflammatory changes surrounding the right greater than left L3-4 facet joints, which may be on a degenerative basis.