Left lower extremity weakness and back pain Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is diffusely heterogeneous similar to prior, which is nonspecific, and without discrete suspicious osseous lesions. The conus medullaris is normal in position.Mild degenerative changes are seen including multilevel disc desiccation with relatively preserved disc heights. Additional details as below: L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: Mild disc bulge, ligamentum flavum thickening, and facet arthropathy. No significant spinal canal stenosis. Mild bilateral neural foraminal narrowing. L4-L5: Mild disc bulge eccentric to the left with dorsal annular fissure, ligamentum flavum thickening, and bilateral facet arthropathy. No significant spinal canal stenosis. There is mild to moderate right neural foraminal stenosis. There is moderate left neural foraminal stenosis, which is slightly worse than prior. Bilateral facet joints are distended with fluid.L5-S1: Mild disc bulge which is eccentric to the left. No significant spinal canal or right neural foraminal stenosis. There is mild to moderate left neural foraminal stenosis similar to prior. Bilateral facet arthropathy with facet joint distention.
1. There is moderate left L4-L5 and mild to moderate left L5-S1 neural foraminal stenosis which may be contributing to patient's left lower extremity weakness. Overall degenerative changes are stable to minimally worse since 1/21/2010. 2. Facet arthropathy at L4-5 and L5-S1 with facet distension similar to prior. Additional details as above.