 For the purposes of numbering, there are 5 nonrib-bearing lumbar vertebral bodies and a transitional segment labeled S1 for the purposes of this report. Please note the numbering is slightly different compared to previous exam dated 3/17/2009. The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body are well-maintained. There is progression of loss of disc height at L5-S1 compared to prior exam. Remaining intervertebral discs heights are maintained. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the mid L2 level.T12-L1: There is minimal disc bulge without significant spinal canal or neural foramina stenosis.L1-2: There is mild facet arthropathy. No significant disc bulge, spinal canal or foraminal stenosis.L2-L3: There is mild interval progression of left paracentral disc extrusion which extends mildly superiorly and inferiorly extends posterior to the L3 vertebral body to the L3-4 disc level, associated with mild spinal canal stenosis. There is mild facet arthropathy. There is mild right neural foraminal narrowing. There is no left neuroforaminal narrowing.L3-L4: There is central disc extrusion which is contiguous with above-described disc extrusion resulting in mild spinal canal stenosis. There is mild facet arthropathy. No neural foraminal narrowing.L4-L5: There is disc bulge. There is facet arthropathy and mild ligamentum flavum thickening. No significant spinal canal stenosis stenosis. There is minimal right neuroforamina narrowing. There is no left neuroforaminal narrowing. L5-S1: There is advanced facet arthropathy. There is mild disc bulge. There is mild to moderate neural foraminal stenosis bilaterally. There is no evidence of spinal canal stenosis.S1-S2: No significant disc bulge or spinal canal or neuroforaminal narrowing is evident.
1. Multilevel degenerative changes with disc extrusion extending from L2-3 to the L3-L4 level which is slightly progressed since the previous study dated 3/17/2009. There is mild associated spinal canal stenosis.2. Neuroforaminal stenosis is relatively worst at the L5-S1 level.3. Please note there is transitional anatomy as described above and the numbering scheme is slightly different from previous study dated 3/17/2009.4. Advanced facet arthropathy at L5-S1, which may be contributing to the patient's back pain.