72 years Female (DOB:9/22/1943)Reason: evaluate for lumbar spine pathology History: low back and LLE painPROVIDER/ATTENDING NAME: MICHAEL J LEE MICHAEL J LEE Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact. There is a scoliotic curvature to the lumbar spine. With a levocurvature to the upper lumbar spine. There is left lateral translation of L3 on L4 and a rotatory component.At L5-S1 there is no significant compromise to the neural foramina. There is bilateral facet hypertrophy at this level. There is a left lateral recess disc protrusion at this level associated with endplate osteophytes which encroaches on the nerve roots at the left lateral recess. There is loss of disc space height at this level as well as left-sided endplate reactive change. The endplate reactive changes bright on T1.At L4-5 there is loss of disc space height, disc desiccation and a left lateral broad-based disc extrusion. Disc material extends behind the left lateral superior aspect of the L4 vertebral body and also extends into the left neural foramen. It is associated with encroachment of the nerve roots at the left lateral recess and the left neural foramen at this level. There is moderate bilateral facet hypertrophy at this level. The facet hypertrophy appears to be worse on the left compared to the right side.At L3-4 there is left lateral translation of L3 on L4 with mild rotation of L3 on L4. There is moderate bilateral facet hypertrophy at this level. There is some narrowing of the spinal canal at this level. There is mild encroachment of the left-sided exiting nerve roots.At L2-3 there is a moderate disc bulge at this level associated with moderate bilateral facet and ligamentum flavum hypertrophy. This results in narrowing of the thecal sac with effacement of spinal fluid surrounding the nerve roots within the thecal sac. Overall there is moderate spinal stenosis at this level. Within the neural foramina the exiting nerve roots are surrounded by fat.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is a large left parapelvic cyst present measuring 26 x 13 mm axial dimensions.
1.There are multilevel degenerative changes present in the lumbar spine with the left lateral translation of L3 and L4 associated with the rotatory scoliosis and a levocurvature to the upper lumbar spine.2.There is moderate spinal stenosis present at L2-3.3.There is encroachment of the left-sided exiting nerve roots within the neural foramen at L4-5 associated with encroachment of the nerve roots at the left lateral recess at this level.