At the L1-L2 level. there is no evidence of canal stenosis or foraminal narrowing.

At the L1-L2 level. there is no evidence of canal stenosis or foraminal narrowing. At the L2-L3 level above described subluxation with disc bulge asymmetric to the right is noted causing mild right foraminal narrowing and mild bilateral lateral recess stenosis without significant central canal stenosis or foraminal narrowing. Mild facet changes are present. At the L3-L4 level. disc bulge with facet changes are present causing mild bilateral foramina! narrowinc and mild canal stenosis. At the L4-L5 level, above described subluxation with disc bulge and osteophyte asymmetric to the left is noted with facet changes causing severe left and moderate right foraminal narrowing. Disc bulge with ligamentous thickening is present causing severe central canal stenosis. At the 1.5-S1 level. osteophyte asymmetric to the right with facet changes are present causing moderate right foraminal narrowing as well as moderate left and severe right lateral recess stenosis. No significant left foraminal narrowing is present. The conus is normal shape and position. There is no evidence of prevertebral or paraspinal soft tissue abnormality. IMPRESSION Osteophyte with facet changes causing moderate right foraminal narrowing at L5-S1 with moderate left and severe right lateral recess stenosis. Grade 1 anterolisthesis of L4 on L5 with severe central canal stenosis and severe left and moderate right foramina! narrowing. Mild bilateral foraminat narrowing at L3-L4. Mild right foraminal narrowing at L2-L3. Very truly yours, PAUL CHOI, M.D. Electronically Signed By: PAUL CHOI, M.D. Date/Time Transcribed: 10/14/15 8:39 am EPSTEIN, JEFFREY ACC:6784742 Exam Date: 10/14/15 DOB: 01/20/1953 EAST RIVER MEDICAL IMAGING, PC www.eastriverimaging.com PET/CT • HIGH FIELD MRI • OPEN MRI • MULTIDETECTOR VOLUME ET (VO) • BONE DENSITY • NI CI E IR MEDICI% E ULTRASOUND • DIGITAL N-121Y • CORONARY CT ANGIOGRAPHY • VIRTUAL COLONOSCOPY • CT, MR -iNGIOGRAPH) EFTA00313755