Low back pain Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits aside from mild L5 on S1 retrolisthesis. Bone marrow signal is benign. There is a T1 hyperintense lesion involving the left aspect of the L3 vertebral body extending into the posterior elements on the left likely representing a hemangioma. There is apparent iso to T1 hyperintense signal involving the ventral aspect of the thecal sac without corresponding T2 signal abnormality and not seen on the sagittal T1-weighted sequence and most likely artifact. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: Minimal disc bulge and facet arthropathy. No spinal canal or neural foraminal stenosis.L2-L3: Minimal disc bulge and facet arthropathy. No spinal canal or neural foraminal stenosis.L3-L4: Minimal disc bulge and facet arthropathy. No spinal canal or neural foraminal stenosis.L4-L5: There is prominent bilateral facet arthropathy, worse on the right and mild distention of the facet joint on the left. There is also a disc bulge with partial effacement of the right subarticular zone. There is mild bilateral neural foraminal stenosis. There is also mild central spinal canal stenosis.L5-S1: Severe loss of disc height with associated fatty endplate marrow signal changes. There is also a prominent posterior osteophyte involving the right ventral aspect of the spinal canal but without significant central spinal canal stenosis. Moderate bilateral facet arthropathy. There is moderate bilateral neural foraminal stenoses.Paraspinous soft tissues are within normal limits.
1. Multilevel degenerative changes in the lumbar spine relatively worse at the L4-L5 and L5-S1 levels. There is up to mild spinal canal stenosis at the L4-L5 level. There is up to moderate bilateral neural foraminal stenoses at the L5-S1 level.2. Advanced facet arthropathy at the L4-L5 level and to a lesser degree at the L5-S1 level which may also be contributing to patient's low back pain.3. Left L3 vertebral body hemangioma extending into the posterior elements. No suspicious osseous lesions.