Reason: Evaluate disc and stenosis History: lower back pain with bilateral LE radiculopathy Vertebral body heights are within normal limits. Minimal straightening of the lumbar spine, otherwise alignment is within normal limits. Mild endplate degenerative changes at L4-L5, unchanged. Multilevel disc desiccation with mild degenerative disc disease at L4-L5 is unchanged. No abnormal signal within the cord or conus which terminates at the lower L2 level at the lower limits of normal.T12-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. Mild facet arthropathy and ligamentum flavum thickening. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. Mild facet arthropathy and ligamentum flavum thickening. No spinal canal or neural foraminal stenosis.L4-L5: Broad-based disc bulge the superimposed right paracentral and foraminal extrusion which effaces the right lateral recess with possible impingement on the descending right L5 nerve root. This represents an increase from the prior exam, where a left-sided protrusion was noted, which is now less prominent. A dorsal annular fissure is noted. Ligamentum flavum thickening and facet arthropathy. Mild-to-moderate spinal stenosis is slightly increased. Mild to moderate right neural foraminal stenosis is slightly increased. Mild left neural foraminal stenosis is unchanged.L5-S1: Small central disc extrusion extending inferiorly. Mild ligamentum flavum thickening. No spinal stenosis. Minimal bilateral neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
Right paracentral disc extrusion with mild foraminal extension at L4-L5 has increased from the prior exam. There is significantly increased effacement of the right lateral recess where there may be impingement of the descending right L5 nerve root. There is mild to moderate central spinal canal stenosis at this level which appears slightly worse.