 There is mild loss of lumbar lordosis. Alignment is grossly within normal limits. Severe degenerative disk disease affects L5-S1, and moderate degenerative disk disease affects L4-5. The other vertebral disk spaces are relatively preserved. Vertebral body heights are preserved without fracture. There is a L2 vertebral body hemangioma, and probable small subcentimeter hemangiomas involving the superior endplate of L3 and the inferior endplate of L4. The conus medullaris terminates at the level of the T12 vertebral body. Image portions the distal cord and nerve roots appear normal in caliber and signal. The imaged paraspinal soft tissues are unremarkable. Additional level specific findings are as follows:T12-L1: No significant degenerative disk disease, central canal, or neural foraminal stenosis.L1-L2: No significant degenerative disk disease, central canal, or neural foraminal stenosis.L2-L3: No significant degenerative disk disease, central canal, or neural foraminal stenosis.L3-L4: Minimal disk bulge and mild facet degenerative changes. No significant neural foraminal or central stenosis.L4-L5: Degenerative disk disease with disk bulge, ligamentum flavum thickening, and advanced facet degenerative changes results in mild central stenosis. There is moderate-severe left and mild to moderate right neuroforaminal narrowing.L5-S1: Severe degenerative disk disease with loss of disc space. There is a disk bulge with central protrusion. There are facet degenerative changes. There is no significant central canal stenosis. Mild to moderate bilateral neuroforaminal narrowing.
1. Degenerative changes in the lumbar spine at the L4-L5 and L5-S1 levels as detailed above. There is mild spinal canal stenosis at L4-L5. Otherwise no significant spinal canal stenosis. There is bilateral neural foraminal narrowing at L4-L5 and L5-S1 as described above.2. Facet arthropathy, particularly at the L4-L5 level, which may be contributory patient's low back pain.