Lumbar spinal stenosis. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is straightening of the spinal curvature as seen before. There is minimal anterolisthesis of L2 on L3 which was not seen in 2012 but present on outside MRI from 12/3/2014. Bone marrow signal is benign. The conus medullaris is normal in position.There is vacuum phenomena involving the discs at the L4-5 and L5-S1 levels as seen diffusely. There is developmental narrowing of the lumbar spinal canal as seen before with superimposed degenerative changes as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Disc bulge and bilateral facet arthropathy which appear slightly worse in the interval. Minimal anterolisthesis not seen previously. There is no significant spinal canal stenosis. There is mild left worse than right neural foraminal stenosis. L3-L4: Disc bulge and bilateral facet arthropathy as well as mild prominence of the dorsal epidural fat. There is mild central spinal canal stenosis. There is mild right neural foraminal narrowing. Left neural foramen is patent.L4-L5: Disc bulge eccentric to the left and bilateral facet arthropathy. There is effacement of the left lateral lateral recess and moderate to severe left neural foraminal stenosis similar to prior. There is mild central spinal canal stenosis. Right neural foramen is patent.L5-S1: Disc bulge, eccentric to the left, and bilateral facet arthropathy. There is no significant central spinal canal stenosis. There is moderate to severe left neural foraminal stenosis and partial effacement of the left lateral recess similar to prior. There is mild right neural foraminal stenosis. Paraspinous soft tissues are within normal limits.
1. There is mild central spinal canal stenosis at the L3-L4 and L4-L5 levels related to combination of developmental narrowing and superimposed degenerative changes similar to prior from 2012. 2. There is moderate to severe left neural foraminal stenosis as well as partial effacement of the left lateral recesses at the left L4-L5 and L5-S1 levels similar to prior. There may be impingement of the left L4 and left L5 nerve roots in the neural foramina and possibly the left S1 nerve root in the lateral recess at the L5-S1 level.3. Overall degenerative findings are stable to minimally worse (such as at the L2-3 level) since prior MRI from 2/22/2012. Please see additional details above.