Reason: back pain History: back pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. Overall the pedicles are thickened short and the spinal canal is small.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a mild disk bulge at this level as well as some mild facet ligamentum flavum hypertrophyAt L4-5 there is no significant compromise to spinal canal or neural foramina. There is a disk bulge at this level associated with disk desiccation and facet and ligamentum flavum hypertrophy. There is effacement of the fat at the lateral recess ease at this level and overall moderate degree of spinal stenosis. There is narrowing of the neural foramina bilaterally at this level. Compared to the 2007 exam there has been some interval progression of spinal stenosis.At L3-4 and the patient is status post left-sided hemilaminotomy. There is loss of disk space height, disk desiccation and diffuse disk bulge at this level associated with some ligamentum flavum hypertrophy. There is some effacement of the fat of the left lateral recess at this level and left hemi-canal . There is narrowing of the neural foramina bilaterally at this level. Overall the degree of encroachment knee left lateral recess is not changed substantially compared to 2007At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is redemonstration and no significant change of a T11-12 disk protrusion without significant compromise of the spinal canal.
1.Since the prior exam the patient has developed spinal stenosis at L4-5.2.There is a redemonstration of encroachment of the nerve roots at the left hemi-canal at L3-4. Differentiation of scar formation from encroachment due to disk material may be possible using a contrast enhanced exam.3.Congenitally narrow lumbar spinal canal.