Lumbosacral spondylosis without myelopathy. Evaluate for lumbar stenosis. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.Rounded areas of T1 and T2 hyperintensity involving L4, L2 and T11 vertebral bodies demonstrating dropout of signal on the STIR are in keeping with benign etiology such as hemangioma or focal fat. Multilevel degenerative changes are seen with endplate irregularity involving L2-L3 levels and Schmorl's nodes noted adjacent to the endplate at several levels. There is disc desiccation at multiple levels with scattered disc narrowing more pronounced at L2-L3 level.L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Disc bulge with right-sided prominence is seen abutting the descending right L3 nerve root. There is mild right neural foraminal stenosis. No central canal stenosis. A lobulated hyperintense T2 lesion seen arising at the level of left L2-L3 facet joint and projecting dorsally most likely represents a synovial cyst.L3-L4: There is diffuse bulging of the disc with right-sided prominence causing moderate right foraminal stenosis and mild left foraminal stenosis. Mild central canal stenosis is seen at this level. There is facet hypertrophy and ligamentum flavum hypertrophy.L4-L5: There is disc bulging underlying a right foraminal protrusion causing severe right foraminal stenosis. There is moderate left foraminal stenosis. There is narrowing of the left lateral recess and moderate central canal stenosis. There are changes of facet arthropathy and ligament flavum hypertrophy.L5-S1: There is disc bulge along with superimposed disc protrusion causing right moderate foraminal stenosis. There is moderate facet arthropathy and ligamentum flavum hypertrophy at this level. There is effusion in the right facet joint. A tiny cystic structure is seen in the region of the right neural foramen likely abutting the exiting L5 nerve root, which may represent a nerve root sleeve cyst or synovial cyst. Mild indentation of the right thecal sac is noted.The right psoas muscle is smaller compared to the left. Otherwise, paraspinal soft tissues are unremarkable.There are rounded T2 hyperintense lesion in the bilateral kidneys measuring 4.2 x 4.2 cm on the right side and about 4.4 x 3.9 cm on the left side most likely cysts.
1. Multilevel moderate degenerative changes most pronounced at L4-L5 level with severe right foraminal stenosis and moderate central canal stenosis.2. Small cystic structure, likely a synovial cyst or perhaps a nerve root sleeve cyst, abutting the exiting right L5 root at the L5-S1 level.3. Rounded T2 hyperintense lesions in the bilateral kidneys, most likely cysts. Follow up ultrasound could be obtained as clinically indicated.