79-year-old female with back pain. Evaluate for lumbar spinal stenosis. Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. There is grade 1 anterolisthesis at L4-5 which appears slightly worse since 12/9/2009 MRI. Alignment is otherwise maintained. Degenerative changes are seen as describe below:At L1-2 there is no significant compromise to spinal canal or neural foramina. Mild facet arthropathy.At L2-3 there is no significant compromise to spinal canal or neural foramina. Mild facet arthropathy.At L3-4 there is no significant compromise to spinal canal or neural foramina. Bilateral facet arthropathy.At L4-5 there is grade 1 anterolisthesis, disc dessication, disc uncovering as well as mild extrusion superimposed on disc bulge. There is also advanced facet arthropathy and evidence of prior decompressive left hemi-laminectomy. There is mild left worse than right neural foraminal stenosis and progressed since 2009. No significant spinal canal stenosis. At L5-S1 there is mild disc extrusion superimposed on diffuse disc bulge, ligamentum flavum thickening, and advanced facet arthropathy particularly on the right. There is moderate right neural foraminal stenosis, which has progressed in the interval. No significant left neural foraminal or spinal canal stenosis. A solid 2 cm lesion along the anterior margin of the right kidney with low T2 signal is noted. Additional left renal cystic lesion is noted.
1. Grade 1 degenerative spondylolisthesis at L4-5 has slightly progressed since 12/9/2009. Interval left decompressive hemi-laminectomy is noted at this level. No significant spinal canal stenosis is appreciated at this level or elsewhere in the lumbar spine.2. Mild left worse than right L4-5 and moderate right L5-S1 neural foraminal stenosis have progressed since 2009. Advanced L4-5 and L5-S1 facet arthropathy again seen. 3. Right renal lesion is again seen and better characterized on prior post-contrast abdominal CT.