Lower extremity weakness and numbness For the purposes of numbering, the most inferior well-defined disc space is labelled L5-S1. Again seen is a severe compression fracture involving the L3 vertebral body with approximately 70% loss of height similar to prior. There is edema involving the L3 vertebral body, also similar to prior. Evidence of cement augmentation at the L3 vertebral body is again seen. No significant osseous retropulsion.Remainder of the vertebral body heights are normal. Alignment is grossly maintained in the lumbar spine. There are diminished posterior osseous elements from L3-L4 to the sacrum reflecting combination of prior laminectomies and dysplasia. Fat within the thecal sac at the right lateral S1 level is again seen. The spinal cord remains low-lying with the distal neural tissue/conus extending to the L5 level. Prone images demonstrate no appreciable ventral motion. Septations/adhesions are again again noted in the thecal sac from the L5 to S1 levels similar to prior. T2 signal likely reflecting myelomalacia at L2-L3 again seen.Degenerative changes are specified by the intervertebral level as follows and unchanged since 2/22/2016: T12-L1: No spinal canal or neural foraminal stenosis.L1-L2: There is bilateral facet hypertrophy and ligamentum flavum thickening. There is minimal disc bulge. There is unchanged mild central canal stenosis and bilateral mild to moderate neural foraminal stenosis.L2-L3: There is bilateral facet hypertrophy and ligamentum flavum thickening. There is diffuse disc bulge with central protrusion component without significant change in moderate to severe spinal canal stenosis and moderate bilateral foraminal stenosis. L3-L4: There is bilateral facet hypertrophy and ligamentum flavum thickening. There is also mild disc bulge with unchanged mild spinal canal stenosis and mild to moderate bilateral foraminal stenosis.L4-L5: There is bilateral facet hypertrophy. There is central disc protrusion. No significant spinal canal stenosis. There is unchanged mild bilateral foraminal narrowing, relatively worse on the left.L5-S1: There is bilateral facet hypertrophy without neuroforaminal narrowing or spinal stenosis.Fatty atrophy involving the paraspinous musculature again seen, which is predominantly on the right.
1. Compared to 3/29/2016 and 2/22/2016, there is no significant change in moderate to severe spinal canal stenosis at the L2-L3 level.2. No significant change in compression fracture with approximately 70% height loss of the L3 vertebral body with evidence of cement augmentation.3. Unchanged appearance of the low-lying conus which extends to the L5 level and adhesions within the distal thecal sac. Prone images demonstrate no appreciable ventral motion, which in the appropriate clinical setting suggests possibility of re-tethering. 4. Unchanged T2 hyperintensity within the cord at the L2-L3 level consistent with myelomalacia.5. Degenerative changes at additional levels as detailed above.