 There is mild dextroscoliosis of the lumbar spine. There is grade 1 approximately 7 mm degenerative anterolisthesis of L4 on L5. There is trace retrolisthesis of L2 on L3. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable. There are multilevel degenerative disc changes mostly involving L4-L5, with endplate marrow changes and moderate loss of disc height. The spinal cord displays normal signal and morphology with conus terminating at T12-L1. The paravertebral soft tissues are unremarkable. There are bilateral Tarlov's cysts at S1 and S2 level, largest measuring 1.8 x 1.3 cm. At T11-T12: There is trace disc bulge and right facet arthropathy. No significant foraminal or spinal canal stenosis.At T12-L1: There is disc bulge with right foraminal prominence resulting in mild to moderate right neuroforaminal narrowing. There is no left neural foraminal narrowing. There is no significant spinal canal stenosis.At L1-L2, there is mild disc bulge and mild facet arthropathy, resulting in mild right and mild to moderate left neuroforaminal narrowing. There is mild spinal canal stenosis. At L2-3, there is uncovering of the disc, facet arthropathy left more than right, and ligamentum flavum thickening. There is disc bulge resulting in mild right and moderate to severe left neural foraminal narrowing. There is mild spinal canal stenosis. At L3-L4, there is minimal disc bulge and facet arthropathy, resulting in moderate to severe left neural foramina narrowing and mild right neuroforaminal narrowing. There is mild spinal canal stenosis.At L4-L5, there is uncovering of the disc and disc osteophyte complex as well as facet arthropathy, with resultant mild to moderate right and moderate left foraminal narrowing. There is moderate spinal canal stenosis at this level. At L5-S1, there is ligamentum flavum thickening and facet arthropathy. There is a sequestered disc fragment which extends along the right paracentral to proximal foraminal level with effacement of right foramen although this probable disk extrusion is not well delineated. There is a sequestered disc fragment extending along the mid posterior L5 body. There is moderate to severe right neural foraminal narrowing. There is no left neuroforaminal narrowing. There is no spinal canal stenosis. There is impingement of the exiting right L5 nerve root, and dorsal displacement of the descending right S1 nerve root.
1. Advanced degenerative disc changes in the lumbar spine predominantly involving L5-S1, with a right paracentral sequestrated disc fragment extending posterior to L5 vertebral body and additional disk material extending along right paracentral/proximal foraminal region, with resultant effacement of the right foramen, impingement of the exiting right L5 nerve root, and dorsal displacement of the descending right S1 nerve root. Moderate-severe right foraminal narrowing.2. There is up to moderate spinal canal stenosis at L4-L5, where there is grade 1 anterolisthesis.3. Moderate to severe neuroforaminal stenosis at L3-L4 and L2-L3 on the left.