 The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body heights are well-maintained. There is moderate loss of disc height at L3-L4 with endplate degenerative changes. There is severe loss of disc height at L4-5 and L5-S1 with endplate degenerative changes. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the L1 level.T12-L1: No disc bulge, spinal canal and foraminal stenosis.L1-L2: Mild disc bulge with progression of right sided prominence, thickening of the ligamentum flavum and facet arthropathy, contributing to mild bilateral foraminal stenosis. No significant spinal canal stenosis.L2-L3: Disc bulge, thickening of the ligamentum flavum and facet arthropathy, contributing to moderate spinal canal stenosis and moderate bilateral foraminal stenosis. L3-L4: The previously seen left superior disc extrusion is significantly decreased in size. Disc bulge with progression of superimposed right foraminal disc protrusion, thickening of the ligamentum flavum and facet arthropathy, contributing to narrowing of the bilateral lateral recesses, moderate to severe spinal canal stenosis and severe bilateral foraminal stenosis. Again seen along the interspinous ligament is either fluid tracking back from a previous ruptured cyst versus other focal fluid.L4-L5: Disc bulge, thickening of the ligamentum flavum and facet arthropathy, contributing to moderate bilateral foraminal stenosis. No significant spinal canal stenosis.L5-S1: Disc bulge, thickening of the ligamentum flavum and facet arthropathy, contributing to severe right and moderate left foraminal stenosis. No significant spinal canal stenosis.
1. Interval significant decrease in left superior disc extrusion at L3-L4 with slight progression of right foraminal disc protrusion. 2. Otherwise, no significant interval change in degenerative lumbar spondylosis as described above, most prominent at L3-L4 with moderate to severe spinal canal stenosis and severe bilateral foraminal stenosis. 