Hi, Before I explain you the meaning of the report, I would like to give some anatomical details. The vertebral column consists of vertebrae. The bodies of vertebrae are separated with disk-shaped cartilages. The posterior elements of the vertebrae comprise a canal where the spinal cord is located and is surrounded with a multilayer coating called thecal sac. There are also little holes on both sides of the vertebral column through which nerves originating from the spinal cord exit (neural foramina). The whole vertebral column is reinforced with tough ligaments both in the anterior and the posterior aspects. These ligaments are called anterior and posterior longitudinal ligaments, respectively. Each vertebra is marked with a letter that corresponds to the anatomic region of the body: C means cervical, T or Th means thoracic, L means lumbar, S is sacral. Now, back to your report. The reports says that the disk-shaped cartilage at L4-L5 bulges out into the left foramina. The word abutting is a little tricky here. It is impossible to understand what the radiologist wanted to say with this word: is the disk compressing L4 nerve or is it just adjacent to L4 nerve and does not compress it? So, here is my suggestion. If you have any pain, numbness or anything alike in your LEFT leg, then L4 nerve is most probably compressed and you may need treatment. If you do not have any symptoms there, just ignore this statement and look for another cause for your back pain. Hope it helps. Kind Regards.