 The last well formed disk space is referred to as L5-S1. There is minimal grade 1 retrolisthesis of L5 on S1, and minimal grade 1 anterolisthesis of L4 on L5. The remainder of the spine shows normal alignment. There is loss of T2 signal in all visualized disks with moderate loss of disk height at L4-5 and L5-S1. There is diffusely heterogeneous marrow signal which is nonspecific. There are type II endplate degenerative changes at L4-5 and L5-S1. There is minimal edema in the right-sided L4 and L5 articulating facets and pedicles which is nonspecific, likely reflecting degenerative process. The conus terminates at L1-2 and shows normal caliber and signal.T12-L1: No disk herniation, central spinal or neural foraminal stenosis.L1-2: No disk herniation, central spinal or neural foraminal stenosis.L2-3: No disk herniation, central spinal or neural foraminal stenosis.L3-4: Minimal disk bulge and bilateral facet arthropathy contributing to mild to moderate bilateral neural foraminal stenosis. No central spinal stenosis.L4-5: Diffuse disk bulge, bilateral facet arthropathy and ligamentum flavum thickening causing moderate right and mild left neural foraminal stenosis and no significant central spinal stenosis. Disk material encroaches upon the bilateral subarticular zones without significant stenosis.L5-S1: Diffuse disk bulge asymmetric to the left with a left foraminal protrusion causing mild to moderate left and minimal right neural foraminal stenosis. No significant spinal canal stenosis.
1.Multilevel lumbar spondylosis with no significant central spinal canal stenosis and variable degrees of neural foraminal stenoses as described above.2.At L5-S1, there is mild to moderate left neural foraminal stenosis secondary to left foraminal disk protrusion and may be impinging on the exiting left L5 nerve root.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.