Circumferential prominence of epidural fat from L4-L5 with scalloping of the thecal sac is consistent with epidural lipomatosis. Combined with moderate-large disc bulge at L4/5 and L5/S1, this results in severe flattening and distortion of the thecal sac and obliteration of CSF around the cauda equina nerve roots. At L4/5, there is also moderate lateral recess stenosis bilaterally with compression of descending L5 nerve roots.