62-year-old man with history of Hodgkin's lymphoma, now with right sciatica. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild straightening of the lumbar spine similar to the prior exam. The L4/5 and L5/S1 intervertebral discs appear desiccated with low T2 signal and loss of height, worsened from the prior exam. Decreased T1 signal and slightly increased T2 signal in the endplates surrounding the L5/S1 disc appears similar to study from 7/2008, likely edematous endplate changes. Additionally, there is increased T1 and T2 signal in the anterior portion of T12, also stable and probably fatty endplate changes. There is no new, focal marrow signal abnormality. The conus medullaris is normal in position at mid-L2.Multilevel degenerative changes are seen, progressed from the prior examination as described below:L1-L2: There is a disc bulge, slightly eccentric to the left, new since prior. There is no spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: There is a disc bulge without significant spinal canal or neural foraminal stenosis.L4-L5: There is a disc bulge with a new right paramedian disc protrusion. Additionally, there is facet arthropathy with ligamentum flavum thickening. This results in mild spinal canal stenosis and significant narrowing of the right lateral recess with impingement of the L5 nerve root. There is minimal bilateral neural foraminal stenosis.L5-S1: There is a disc bulge. Additionally, there is facet arthropathy with ligamentum flavum thickening. There is no spinal canal stenosis. There is mild to moderate right and moderate left neural foraminal stenosis.There are multiple left renal cysts. The paraspinal soft tissues are otherwise within normal limits.
1.Progressive multilevel degenerative disease in the lumbar spine, worst at L4-5 at which there is a new disc protrusion with effacement of the right lateral recess and suspected impingement on the right L5 nerve root.2.There is also mild to moderate right and moderate left L5-S1 neural foraminal stenosis. Additional details as above.3.Within the limits of noncontrast examination, no findings to suggest active lymphomatous lesions.