Female, 70 years old, with left lower extremity radicular pain. Prior imaging showed L5-S1 nerve impingement. A trace retrolisthesis of L5 relative to S1 is noted. Spinal alignment is otherwise unremarkable. Vertebral body heights are preserved. A Schmorl's node is evident at L1-2. Mild endplate degenerative signal is seen at L5-S1. No concerning marrow replacement is detected. Edema is demonstrated within the L5 pedicles.The visualized distal spinal cord and conus are unremarkable. No epidural abnormalities are suspected.Since the prior examination, loss of disc height has progressed at L1-2 and L5-S1. All of the lumbar discs demonstrate loss of T2 signal. Additional level specific findings are as follows:L1-2: Mild facet hypertrophy. Bulging disc asymmetric to the right with a possible right foraminal protrusion. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing, slightly progressed. L2-3: Facet hypertrophy and ligamentum flavum thickening. Minimal bulging disc. No significant spinal canal or foraminal stenosis. No interval changes. L3-4: Facet hypertrophy and ligamentum flavum thickening. Minimal bulging disc. Mild spinal canal narrowing. No significant foraminal narrowing. No interval changes. L4-5: Facet hypertrophy and ligamentum flavum thickening, progressed, particularly on the left. Bulging disc, not significantly changed. Generalized spinal canal stenosis with particular effacement of the left lateral recess and likely impingement of the descending left L5 nerve root. The neural foramina are not significantly narrowed. L5-S1: Facet hypertrophy. Mild bulging disc. A previously seen left paracentral and subarticular protrusion has resolved. There is no significant spinal canal stenosis. Severe right and moderate left foraminal narrowing, unchanged.
1.Progressive facet and ligamentous degeneration on the left at L4-5 which results in a worsened left lateral recess narrowing and possible impingement of the descending left L5 nerve root.2.A previously seen disc protrusion at L5-S1 has resolved with no significant residual canal stenosis or nerve impingement. The right foramen at this level is, however, significantly narrowed.3.No additional areas of high-grade spinal canal or foraminal stenosis are seen.