Normal lumbar spinal alignment and segmentation. There is moderate degenerative change at the upper two lumbar disc levels, mild disc degeneration at L3-L4 and L4-L5 and advanced disc degeneration at L5-S1. There are only minor disc bulges which are not resulting in any thecal sac compression, but there is fairly extensive epidural lipomatosis which is compromising the theca particularly from L2-L3 distally where no CSF is seen on the T2-weighted sequences. The thecal sac is displaced anteriorly at this level.
The distal thoracic cord and conus appear intact and no foraminal nerve root compression is identified. No significant marrow lesion has been demonstrated, and no abnormality is seen in the pre-sacral space or the imaged portion of the sacrum. The facet joints and neural arches are well-maintained.