Bilateral lumbar radicular symptoms, evaluate for change since prior MRI Five lumbar type vertebral bodies are presumed to be present. There is minimal depression involving the superior endplate of the L1 vertebral body similar to prior with a small Schmorl's node at this level also noted. Vertebral body heights are otherwise maintained. There is grade 1 anterolisthesis of L4 and L5 similar to prior. Alignment in the lumbar spine is otherwise maintained. Bone marrow signal is benign with small T1 hyperintense foci such as at the left aspect of the L4 vertebral body and posterior T10 vertebral body are compatible with small hemangiomas. The conus medullaris is normal in position.There is advanced facet arthropathy at the L4-L5 level with mild distention of the facet joints and mild edema involving the surrounding paraspinous soft tissues. Facet arthropathy with distention of the facet joints also noted at L3-L4. These facet effusions are slightly increased in the interval, particularly on the left. Additional details regarding multilevel degenerative changes as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L3-L4: Mild disc bulge. Bilateral facet arthropathy with distention of the facet joints. No spinal canal or neural foraminal stenosis.L4-L5: Disc desiccation with mild to moderate height loss is minimally worse in the interval. Grade 1 anterolisthesis and advanced bilateral facet arthropathy are similar to prior although there appears to be mild increase in adjacent soft tissue edema associated with the facet arthropathy. There is also mild disc bulge, ligamentum flavum thickening and mild prominence of the dorsal epidural fat. There is resulting moderate degree of spinal canal stenosis. There is also mild bilateral neural foraminal stenosis. These findings are stable to minimally worse in the interval.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.Cysts in the inferior pole of the right kidney again seen. Multiple cysts in the liver better seen previously.
1. Multilevel degenerative changes, worst at the L4-L5 level where there is grade 1 anterolisthesis, advanced facet arthropathy, and moderate spinal canal stenosis which is stable to minimally worse since 3/13/2015. There is mild bilateral neural foraminal stenosis at this level similar to prior. 2. Multilevel facet arthropathy, worst at the L4-L5 level, with mild interval increase in facet effusions at the left L4-L5 and bilateral L3-L4 levels. There is also mild paraspinous soft tissue edema associated with the facet arthropathy which is increased in the interval.