Male, 61 years old, with weakness in the left quadriceps muscle, evaluate lumbar spondylosis, specifically the left L3 nerve root. Trace retrolisthesis of L4 relative to L5 is unchanged. Spinal alignment is otherwise unremarkable.Mild anterior wedging of the T11 and T12 vertebral body is unchanged. Vertebral body heights are otherwise preserved. Marrow signal characteristics are slightly heterogeneous which in part represents endplate degenerative signal abnormality. No focal worrisome marrow replacement or marrow edema is seen.Mild focal myomalacia of the spinal cord at the T11-12 level is unchanged. Elsewhere, the visualized distal spinal cord, conus and nerve roots of the cauda equina are normal in signal characteristics.Diffuse loss of disc height is seen with the exception of L5-S1 which demonstrates relatively preserved disc height. The discs show uniformly T2 signal. Additional level specific findings are as follows:T11-12: Evidence of prior posterior element surgery. Left facet arthropathy. Disc bulging with a small left foraminal protrusion. Mild generalized spinal canal stenosis. Moderate bilateral foraminal narrowing. No interval changes. T12-L1: Facet arthropathy. Ligamentum flavum thickening. Minimal disc bulge. Mild spinal canal stenosis. Mild bilateral foraminal narrowing. No interval changes.L1-2: Facet arthropathy. Ligamentum flavum thickening. Moderate generalized spinal canal stenosis with some crowding of the cauda equina. Mild bilateral foraminal narrowing.L2-3: Facet arthropathy. Ligamentum flavum thickening. Disc bulging. Mild generalized spinal canal stenosis. Moderate bilateral foraminal narrowing. No interval changes. L3-4: Facet arthropathy, left worse than right. Minimal disc bulging. Mild generalized spinal canal stenosis. Severe left and moderate right foraminal narrowing. No interval changes. L4-5: Facet arthropathy. Ligamentum flavum thickening. Bulging disc with a small right paracentral protrusion. Mild generalized spinal canal stenosis. Moderate bilateral foraminal narrowing. No interval changes. L5-S1: Facet arthropathy. Ligamentum flavum thickening. Bulging disc with a small central protrusion. Mild generalized spinal canal stenosis. Severe left and mild right foraminal narrowing. No interval changes.
Multilevel degenerative disease of the discs and posterior elements is redemonstrated without significant interval change. As on the prior examination, severe foraminal narrowing is demonstrated on the left at L3-4 and on the left at L5-S1. Moderate spinal canal stenosis is seen at L1-2 with some crowding of the cauda equina. Mild spinal canal narrowing is also evident at additional levels as above.