Male, 53 years old, with chronic low back pain, right leg pain, left leg weakness. Spinal alignment is anatomic. Vertebral body heights are preserved. A lumbosacral transitional morphology is evident at L5.Fatty degenerative endplate signal abnormality is seen at L2-3 and to a lesser extent at L3-4, similar to prior study. Both disc levels demonstrate degeneration with endplate irregularity and progressive loss of disc height at L3-4. Small Schmorl's nodes are evident T12-L1. The visualized distal spinal cord and conus are within normal limits.The spinal canal remains congenitally slender. Prominent dorsal epidural fat is seen. Multilevel superimposed degenerative findings are as follows:T12-L1: Mild facet hypertrophy. Mild disc bulge. Mild spinal canal narrowing. Mild bilateral foraminal narrowing. No significant interval changes. L1-2: Progressive facet hypertrophy and ligamentum flavum thickening. Minimally progressive disc bulging. Moderate generalized spinal canal narrowing with crowding of the cauda equina, slightly worse than prior. Mild bilateral foraminal narrowing, unchanged. L2-3: Facet hypertrophy and ligamentum flavum thickening, slightly progressed. Loss of disc height and disc bulging with osteophytic ridging. Moderately severe spinal canal stenosis with crowding of the cauda equina. Moderate bilateral foraminal narrowing. No significant interval changes. L3-4: Marked facet arthropathy and ligamentum flavum thickening, slightly progressed from prior. Progressive loss of disc height with bulging and osteophytic ridging. Severe spinal canal stenosis with exclusion of CSF and crowding/impingement of the cauda equina, not definitely changed. Severe bilateral foraminal narrowing, slightly progressed on the left. L4-5: Marked facet arthropathy and ligamentum flavum thickening, slightly progressed. Disc bulging, similar to prior. Severe spinal canal stenosis with exclusion of CSF and crowding/impingement of the cauda equina, similar to prior. Severe bilateral foraminal narrowing, unchanged. L5-S1: Facet arthropathy, slightly progressed. Disc bulging asymmetric to the left with effacement of the left lateral recess. Mild spinal canal stenosis, progressed. Severe bilateral foraminal narrowing, progressed on the left.
Multilevel degeneration of the disks and posterior elements is redemonstrated with mild progression at most levels when compared to the prior examination. In particular, there is a severe degree of spinal canal stenosis at L3-4 and L4-5 with crowding/impingement of the cauda equina.