Findings:
There is a redemonstrated acute/subacute L4 burst fracture with 50% height loss resulting in 6mm retropulsion of the posterior aspect of the L4 vertebral body. The fracture extends into the pedicles and results in edema in the paravertebral soft tissues and medial psoas muscles. There is mild edema in the L5-S1 endplates. There is severe stenosis of the spinal canal at the level of the L4 vertebral body which extends from L3-L4 to L4-L5 levels. There is redundancy of the cauda equina nerve roots just above the area of narrowing. There is mild dorsal epidural lipomatosis. There are chronic, multilevel degenerative changes as follows; L2-L3: Moderate bulge and facet and ligamentum flavum hypertrophy with effacement of the lateral recess. There is mild central spinal canal and inferior neural foraminal narrowing. L3-L4: Moderate bulge, facet arthropathy and hypertrophy, ligamentum flavum redundancy resulting in severe spinal canal narrowing. L4-L5: Small disc bulge, ligamentum flavum hypertrophy, bilateral facet arthropathy with small facet joint effusions resulting in moderate spinal canal narrowing. There is moderate to severe narrowing of the bilateral neuroforamina, left greater than right. L5-S1: There is a disc bulge, facet and ligamentum flavum hypertrophy causing mild spinal canal and mild to moderate bilateral neuroforaminal narrowing, right greater than left. There is mild facet degeneration and joint effusion.

Impression:
There is an acute/subacute burst fracture at the L4 vertebral body with approximately 6mm of retropulsion. This results in significant spinal canal and neural foraminal stenosis at L3-L4 and L4-L5 and paravertebral soft tissue edema. There are tortuous and redundant cauda equina nerve roots above the level of the spinal stenosis. There is advanced facet disease, worst at L4-L5.

Recommendations:
For your training purposes, recommendations are not included in this report.