Right foot drop. Evaluation of cause of foot drop, radiculopathy, sensorimotor neuropathy. Five lumbar type vertebral bodies are presumed to be present. The conus medullaris is normal in position. There is depression involving the superior endplate of the L4 vertebral body suggesting a mild chronic compression fracture and Schmorl's node. Vertebral body heights are otherwise maintained. There is minimal retrolisthesis of L1 on L2 and L2 on L3 as well as grade 1 anterolisthesis of L4 and L5. Bone marrow signal is benign. There is moderate to severe disc height loss throughout the lumbar spine, particularly at the L2-L3 and L5-S1 levels where there is severe disc height loss with adjacent edematous endplate marrow signal changes which are on a degenerative basis. Edematous marrow signal changes are also present involving the inferior endplate of the T12 vertebral body. Additional details regarding degenerative changes as described below:T11-T12: No significant spinal canal or neural foraminal stenosis. There appears to be a subligamentous central disc extrusion which extends caudally along the posterior aspect of the T12 vertebral body to the T12-L1 level. T12-L1: No significant spinal canal or neural foraminal stenosis. Minimal disc bulge as well as bilateral facet arthropathy.L1-L2: Mild disc bulge, ligamentum flavum thickening and facet arthropathy. There is no significant spinal canal stenosis. There is mild left neural foraminal stenosis.L2-L3: Prominent disc bulge, ligamentum flavum thickening, as well as facet arthropathy. There is resulting moderate to severe central spinal canal stenosis. There is also effacement of the lateral recesses, particularly on the right. There is moderate left and minimal right neural foraminal stenosis. There may be impingement of the exiting left nerve root extraforaminally.L3-L4: Disc bulge, advanced bilateral facet arthropathy, and ligamentum flavum thickening with moderate to severe spinal canal stenosis including partial effacement of the lateral recesses. There is moderate left neural foraminal stenosis and mild to moderate right neural foraminal narrowing.L4-L5: Advanced facet arthropathy with grade 1 anterolisthesis. There is prominent ligamentum flavum thickening and disc uncovering. There is severe spinal canal stenosis at this level. There is also severe right and mild to moderate left neural foraminal stenosis.L5-S1: There is disc bulge, moderate facet arthropathy, ligamentum flavum thickening. There is no significant central spinal canal stenosis. There is however partial effacement of the right lateral recess with contact of the right S1 nerve root. There is mild to moderate bilateral neural foraminal stenosis.Paraspinous soft tissues are within normal limits. There are multiple bilateral renal cysts. Linear enhancement involving the spinal canal is at least predominantly vascular in etiology. There are no suspicious enhancing lesions.
1. Advanced degenerative changes throughout the lumbar spine, worst at the L4-5 level where there is grade 1 degenerative spondylolisthesis, severe spinal canal stenosis, and severe right-sided neural foraminal stenosis.2. There is also moderate to severe spinal canal stenosis at the L3-L4 and L2-L3 levels. Additional details including foraminal stenosis at additional levels as detailed above.3. Linear enhancement within the spinal canal is at least predominantly related to normal vascular structures. Possibility that some of the linear enhancing structures represent enhancing cauda equina nerve roots is not entirely excluded, but this can also be related to the high-grade stenosis described above rather than imply an inflammatory process.