Leg pain, spinal stenosis, multilevel disc disease. Compare with prior. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There appears to be some levoscoliosis at the lower lumbar level which can be better assessed with standing radiographs. No significant spondylolisthesis. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:T12-L1: Mild disc bulge and loss of disc height similar to prior. No significant spinal canal or neural foraminal stenosis.L1-L2: Loss of disc height and minimal bulge similar to prior. There is also mild facet arthropathy. No significant spinal canal or neural foraminal stenosis.L2-L3: There is loss of disc height, ligamentum flavum thickening, and bilateral facet arthropathy. There is also prominence of the dorsal epidural fat. There is moderate to severe spinal canal stenosis at this level which is slightly worse than prior. There is effacement of the right lateral recesses, right worse in left. There is moderate right neural foraminal stenosis which is worse. There is no significant left neural foraminal stenosis.L3-L4: There is disc bulge, and bilateral facet arthropathy resulting in mild spinal canal stenosis at this level which is slightly worse. There is mild to moderate right and mild left neural foraminal stenosis similar to prior.L4-L5: There is progression of disc height loss at this level as well as left greater than right facet arthropathy and ligamentum flavum thickening which have progressed resulting in moderate central canal stenosis, particularly involving the left aspect of the thecal sac. There is also effacement of the left lateral recess which appears slightly worse. There is severe left and mild to moderate right neural foraminal stenosis stable to minimally progressed on the left since prior. There is evidence of prior right-sided laminotomy.L5-S1: Tiny central disc protrusion similar to prior. No spinal canal or neural foraminal stenosis. Bilateral facet arthropathy.Bilateral renal cysts again seen.
Advanced degenerative changes in the lumbar spine with significant spinal canal stenosis at the L2-L3 and L4-L5 levels which has mildly worsened since 10/25/2011. There is also multilevel neural foraminal stenosis, worst at the right L2-L3 and left L4-L5 levels. Please see details above.