Waldenstrom's macroglobulinemia status-post stem cell transplant, lumbar pain without radicular symptoms. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is mildly heterogeneous, but predominantly fatty-replaced. At L2-3, there is slight disc bulge with mild bilateral neural foraminal stenosis. At L3-4, there is ligamentum flavum hypertrophy and right greater than left facet joint hypertrophy causing moderate right neural foraminal and right lateral recess stenosis. At L4-5, there is a disc-osteophyte complex and bilateral facet joint hypertrophy causing spinal canal stenosis with apparent compression of the bilateral descending nerve roots and moderate bilateral neural foraminal stenosis. At L5-S1, there is a mild disc bulge with effacement of the right lateral recess with impingement upon the adjacent descending nerve roots, as well as bilateral facet hypertrophy causing moderate to severe bilateral neural foraminal stenosis. There is a subcentimeter sacral perineural cyst. The spinal cord displays normal signal and morphology with the conus medullaris lies at the inferior L1 level. The paravertebral soft tissues are unremarkable.
Multilevel lumbar spondylosis with moderate right neural foraminal stenosis and right lateral recess stenosis at L3-4, moderate bilateral neural foraminal stenosis and spinal stenosis at L4-5 with apparent compression of the bilateral descending nerve roots, as well as moderate to severe bilateral neural foraminal stenosis and effacement of the right lateral recess at L5-S1.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.