Findings: Surgical changes including at the lower spine are noted. Multi-level degenerative changes are identified including disc space narrowing and desiccation and end plate changes. Conus ends at approximately the L1 level. For purposes of this discussion, it is assumed that the lowest square/rectangular vertebral body on the sagittal images represent L5.

At the T11-12 level, there is a left central, paracentral, and foraminal protrusion with no significant central canal or neural foraminal stenosis.

At the T12-L1 level, there is slight circumferential disc bulging with a superimposed right forminal protrusion of about 3.5mm and mild bilateral facet hypertrophy leading to mild to moderate right neural foraminal stenosis and no significant stenosis of the central canal or of the left neural foramen. The AP diameter of the sac is about 10.2mm.

At the L1-2 level, there is a mild disc bulge with superimposed bilateral foraminal protrusions of about 1.7mm on the left and 2.4mm on the right with moderate bilateral facet and ligamentum flavum hypertrophy leading to moderate bilateral neural foraminal stenosis; at this elvel, the AP diameter of the sac is roughly 7.8mm.

At the L2-3 level, there is prominent circumferential disc bulging and moderate to severe bilateral facet and ligamentum flavum hypertrophy with superimposed bilateral foraminal protrustions of about 2.2mm leading to moderate to severe bilateral, right greater then left, neural foraminal stenosis and narrowing of the central canal to an AP diameter of about 5.3mm with the posterolateral aspects of the sac compressed by prominent facets and ligamentum flavum.

At the L3-4 level, there is a prominent circumferential disc bulge and severe bilateral facet and ligamentum flavum hypertrophy leading to severe bilateral neural foraminal stenosis and narrowing of te central canal to an AP diameter of about 4.5mm. There is a broad-based disc herniation centrally, left paracentrally, and left foraminally measuring about 3.4mm with a base of 2.4cm.

At the L4-5 level, there is a moderate circumferential disc bulge with a superimposed central, right paracentral, and right foraminal protrusion of about 2.5mm with a broad base of 2.2cm together with moderate bilateral facet hypertrophy leading to severe right and moderate to severe left neural foraminal stenosis; surgical changes are noted at this level with AP diameter of the sac about 9mm.

At the L5-S1 level, there is a circumferential disc bulge to a moderate degree with a superimposed central and right paracentral disc herniation of nearly 4.8mm together with moderate bilateral facet and ligamentum flavum hypertrophy leading to moderate to sever left and moderate right neural foraminal stenosis and significant extension at the right paracentral disc herniation into the central canal narrowing the sac to an AP diameter of about 5.4mm.

Impression:

Severe multi-level degenerative changes especially extending between the L2-3 and L5-S1 levels with severe central stenosis and severe neural foraminal stenosis and with superimposed disc herniations at multiple levels; for additional detail, please refer to body of dictation. Surgical changes are noted at multiple levels of the lower spine, including to the right side of L4-5 with multi-level patchy heterogeneous enhancement consistent with scar.


HELP..... I am driving myself nuts trying to decifer what is going on with me. I was diagnosed last week with severe foot drop