Other intervertebral disc degeneration, lumbar region [M51.36], Reason for Study: ^Reason: radicular pain, back pain History: radicular pain, back pain. The lumbar lordosis is preserved. There is minimal retrolisthesis of L2 over L3 and mild anterolisthesis of L3 over L4, L4-L5, and L5 over S1. The vertebral body heights are maintained. Mild multilevel loss of intervertebral disc space is demonstrated. The conus terminates at L1. There is a small focus of T2 hyperintensity involving the spinal cord at T8-T9 level. Redundancy of the cauda equina is noted. There are multilevel degenerative changes of the lumbar spine as described below in detail. Of note, T8-T10 levels are only imaged in sagittal plane. T8-9: There is a disc bulge resulting in moderate central and mild bilateral neuroforaminal stenosis.T9-T10: There is a disc bulge with mild central and mild to moderate bilateral neuroforaminal stenosis, slightly worsened since prior examination.T10-T11: There is a disc bulge and small extrusion with superimposed hypertrophy of the ligamentum flavum resulting in mild spinal and mild to moderate bilateral neuroforaminal stenosis not significant changed from prior examination.T11-T12: Minimal disc protrusion, hypertrophic degenerative changes of the facets and ligamentum flavum without significant foraminal or central spinal stenosis.T12/L1: Facet disease and ligamentum flavum hypertrophy without significant central canal or neural foraminal stenosis.L1/2: Facet disease and ligamentum flavum hypertrophy without significant central canal or neural foraminal stenosis.L2/3: There is a disc bulge with hypertrophic degenerative changes of the posterior facet and ligamentum flavum resulting in moderate central and moderate bilateral neuroforaminal stenosis, not significantly changed since prior examination.L3/4: There is a disc bulge with advanced hypertrophic degenerative changes of the facets and ligamentum flavum resulting in severe spinal and bilateral neuroforaminal stenosis, slightly progressed since prior examination.L4/5: Disc bulge and hypertrophy of the facets and ligamentum flavum result in mild to moderate bilateral neuroforaminal and mild central spinal stenosis.L5/S1: Disc bulge with superimposed facet/ligamentous hypertrophic degenerative changes resulting in moderate left and mild to moderate right neuroforaminal stenosis.There are bilateral simple appearing renal cysts.
1. Multi-level marked degenerative disk disease as detailed above, most severe at L3-L4 and L4-L5, including spinal canal stenosis and neural foraminal stenosis. These findings are slightly progressed since 2012.2. Degenerative changes of the visualized lower thoracic spine included probable spinal cord impingement at T8-T9 where there is a small area of cord signal suggestive of myelomalacia or edema. Dedicated thoracic imaging can be obtained as clinically warranted.