70-year-old male with back pain and abnormal CT For purposes of numbering, the lower-most level containing a well-formed disc is considered to be L5/S1. With this numbering nomenclature, there is L5 transitional anatomy, and the lower-most level containing ribs is T11. This is the same nomenclature utilized for the two comparison lumbar spine CT exams.There is normal lordotic curvature and alignment of the lumbar spine. The vertebral body heights are preserved. A chronic left L4 pars defect is better demonstrated by prior CT technique. No other fracture or destructive osseous lesion is seen.There is disc desiccation as well as mild disc height loss involving the L3-4 level and moderate disc height loss involving the L4-5 and L5-S1 levels. The paraspinal soft tissues are unremarkable.T12-L1 and L1-L2: No neural foraminal or spinal canal stenosis. These findings are unchanged.L2-L3: Mild disc bulge. Mild facet arthropathy. No spinal canal stenosis. Mild bilateral neural foraminal stenosis. These findings are unchanged.L3-L4: Diffuse annular disc bulge, moderate facet arthropathy, and ligamentum flavum hypertrophy. Moderate central, marked bilateral lateral recess, and moderate bilateral neural foraminal stenosis. These findings are unchanged.L4-L5: Evidence of prior partial laminectomy, at least on the left if not bilaterally. There is diffuse annular disc bulge with a superimposed right paracentral disc extrusion which extends below the disc level. There is also severe facet arthropathy and ligamentum flavum thickening. There is moderate to severe central, moderate to marked left lateral recess, marked right lateral recess, moderate to severe left neural foraminal, and moderate right neural foraminal stenosis. These findings are unchanged.L5-S1: Mild disc bulge, severe facet, and severe arthropathy of the articulation between the L5 vertebral body and the sacral ala. No significant spinal canal stenosis. There is mild bilateral neural foraminal stenosis with abutment and flattening of bilateral S1 nerve root sheath origins. These findings are unchanged.
1.For purposes of numbering, the lower-most level containing a well-formed disc is considered to be L5/S1. With this numbering nomenclature, there is L5 transitional anatomy, and the lower-most level containing ribs is T11. This is the same nomenclature utilized for the two comparison lumbar spine CT exams.2.L2-L3: Mild bilateral neural foraminal stenosis, unchanged.3.L3-L4: Moderate central, marked bilateral lateral recess, and moderate bilateral neural foraminal stenosis, unchanged.4.L4-L5: Moderate to severe central, moderate to marked left lateral recess, marked right lateral recess, moderate to severe left neural foraminal, and moderate right neural foraminal stenosis, unchanged.5.L5-S1: Mild bilateral neural foraminal stenosis with abutment and flattening of bilateral S1 nerve root sheath origins, unchanged.