Normal segmentation. Grade 1 anterior spondylolisthesis at L3-4 secondary to bilateral degenerative pars defects. There less pronounced grade 1 anterior spondylolisthesis of L4 on L5 secondary to a left-sided pars defect. Extensive lumbar disc degeneration throughout the lumbar spine which is most marked at the L3-4 level with height loss
• At L1-2, generalised circumferential disc bulge with known neural compromise.
• At L2-3, general disc bulge with a small right paracentral disc protrusion impinging on the right L3 nerve without overt compression with lateral recess narrowing. Note is made of significant fluid signal between the spinous processes of L2 on L3 in keeping with Baastrups disease
• At L3-L4, intervertebral osteochondrosis or chronic high intensity zone anteriorly-round type is notec. A combination of the spondylolisthesis and disc bulge and disc height loss may impinge bilateral exiting L3 nerve roots. Mild right and left l3 foraminal narrowing. There is definite lateral recess narrowing with no overt nerve compression.
• At L4-5, a combination of anterior spondylolisthesis, circumferential disc bulge and severe bilateral facet joint and ligamentum flavum hypertrophy causes severe central canal stenosis with only a trace of CSF seen surrounding the cauda equina nerve roots. There is most certainly compression of bilateral traversing L5 nerve roots. No exit foramen pathology is seen. Inflammatory oedema superior endplate L5 appreciated. Extensive fluid signal within the bilateral facet joint raises the possibility of inflammation.
• At L5-S1, minor circumferential disc bulge but without central, lateral recess or foraminal compromise.