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

At the L1-L2 level. there is no evidence of canal stenosis or foramina' narrowing. At the L2-L3 level. above described subluxation with disc bulge asymmetric to the right is noted causing mild right foramina' narrowing and mild bilateral lateral recess stenosis without significant central canal stenosis or foramina! 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 L5-S1 level, osteophyte asymmetric to the right with facet changes are present causing moderate right foramina' narrowing as well as moderate left and severe right lateral recess stenosis. No significant left foramina' 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 let 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 foraminal narrowing at L3-L4. Mild right foramina! 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 vevAv.eastrIverlmaging.com PET/CT • HIGH FIELD 3IRI • OPEN MRI • MULTIDETECTOR VOLUME CT (VC) • BONE DENSITY • NUCLEAR MEDICINE ULTRASOUND • DIGIE4L X-R4Y • CORONARY CT ANGIOGRAPHY • VIRTUAL COLONOSCOPY • CT/MR ANGIOGRAPHY EFTA00314031