Low back pain, evaluate for lumbar stenosis. Please note for the purposes of numbering, there appear to be 6 nonrib-bearing lumbar type vertebral bodies. The most inferior well-defined disc space is labeled L6-S1. Vertebral body heights are grossly maintained without evidence of an acute compression fracture. There is minimal retrolisthesis of L2 on L3 and L4 on L5. Bone marrow signal is benign, with prominent edematous marrow signal changes noted involving the inferior L3 vertebral body and to a lesser degree involving the endplates more inferiorly related to degenerative disease. There is severe disc height loss affecting the L2-L3, L4-L5, and L5-L6 levels. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: There is disc bulge and bilateral facet arthropathy. There is no significant spinal canal stenosis. There is relatively mild bilateral narrowing of the neural foramina, however, the exiting right-sided nerve root may be impinged extra-foraminally related to prominent right lateral osteophyte.L3-L4: There is moderate to severe spinal canal stenosis related to disc bulge, facet arthropathy, ligamentum flavum thickening, and prominence of the dorsal epidural fat at this level. There is moderate to severe right and moderate left neural foraminal stenosis.L4-L5: Mild retrolisthesis and bilateral facet arthropathy contribute to partial effacement of the lateral recesses, right worse than left, but without significant central canal stenosis. There is severe right and moderate left neural foraminal stenosis.L5-L6: There is a dorsal annular fissure with tiny central protrusion superimposed on a mild bulge. There is bilateral facet arthropathy, more advanced on the right. There is mild effacement of the right lateral recess. No significant central canal stenosis. There is moderate to severe right and moderate left neural foraminal stenosis. L6-S1: No significant disc disease. No spinal canal or neural foraminal stenosis.Paraspinous soft tissues demonstrate some lower lumbar paraspinous muscular atrophy but are otherwise unremarkable.
1. Please note transitional anatomy with 6 presumed lumbar type vertebral bodies and the most inferior preserved disc space labeled L6-S1 for the purposes of this study.2. Degenerative changes throughout the lumbar spine with up to moderate to severe spinal canal stenosis at the L3-L4 level. Multilevel neural foraminal stenosis is also seen as detailed above.