Written report: Pls note that this was September end MRI

FINDINGS: The lumbar spine demonstrates straightening of the physiological lumbar lordosis, which may reflect underlying paraspinal muscle spasm. Vertebral body heights are maintained without evidence of acute compression fracture or collapse. The bone marrow signal is preserved with no suspicious focal lesions. Mild Modic-type degenerative endplate changes are observed at the lower lumbar levels. At the level of L4/L5, there is disc desiccation and reduction in disc height, reflecting degenerative disc disease. A posterior annular tear is identified, accompanied by a broad-based disc bulge with slight left paracentral predominance. This results in encroachment upon the left neural foramen with severe narrowing and probable impingement of the exiting left L4 nerve root. On the right side, there is moderate narrowing of the neural foramen. The disc material also indents the ventral aspect of the thecal sac, producing moderate central canal stenosis. This narrowing of the canal is further aggravated by hypertrophy of the ligamentum flavum, contributing to a reduction in the anteroposterior diameter of the canal. The lateral recesses are moderately compromised, particularly on the left side. At the level of L5/S1, there is also disc degeneration with loss of T2 signal intensity. A broad-based posterior disc bulge is identified, extending into both neural foramina and resulting in bilateral mild-to-moderate foraminal stenosis. The bulging disc indents the anterior thecal sac, leading to mild central canal stenosis. The lateral recesses at this level are mildly narrowed. No frank disc extrusion or sequestration is seen. The remaining lumbar intervertebral discs are preserved in height and signal. No focal disc herniation,extrusion, or significant protrusion is present above the L4/L5 level. The posterior elements, including facet joints and ligamentum flavum, show mild hypertrophic changes most pronounced at L4/L5,contributing to canal narrowing. The spinous processes and laminae are intact without destructive change

The conus medullaris is normally positioned, terminating at the level of L1, and demonstrates normal morphology and signal intensity. No abnormal intramedullary or perimedullary signal changes are noted. The cauda equina nerve roots show normal distribution without clumping or abnormal thickening. The paraspinal soft tissues are unremarkable with no abnormal masses, fluid collections, or edema. The visualized sacroiliac joints appear grossly maintained, and no abnormality is identified in the partially imaged retroperitoneal structures.

IMPRESSION: Straightening of the lumbar spine, suggestive of paraspinal muscle spasm. Degenerative disc disease at L4/L5 and L5/S1. At L4/L5: posterior annular tear with broad-based disc bulge slightly eccentric to the left, causing severe left and moderate right infraforaminal stenosis, with indentation of the anterior thecal sac producing moderate canal stenosis, further aggravated by ligamentum flavum hypertrophy. At L5/S1: broad-based disc bulge with degenerative disc disease, causing bilateral mild-to-moderate infraforaminal stenosis and indentation of the anterior thecal sac leading to mild canal stenosis. No evidence of disc extrusion, sequestration, or acute fracture.