Gait disequilibrium, evaluate for lumbar spinal stenosis Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of L4 and L5 similar to prior. Alignment is otherwise maintained. Bone marrow signal is benign including hemangioma involving the L2 vertebral body. The conus medullaris is normal in position at the mid L2 level. There is fibrofatty infiltration of the filum terminale measuring less than 2 mm at the L5-S1 level. Small Schmorl's nodes are evident at the L2 level, new at the superior L2 endplate.Multilevel degenerative changes are seen, as described below:L1-L2: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L2-L3: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L3-L4: Disc bulge with small central protrusion which is slightly worse since prior. There is however no significant spinal canal stenosis. There is mild right and minimal left neural foraminal stenosis.L4-L5: There is moderate bilateral facet arthropathy and minimal/grade 1 anterolisthesis. There is no significant spinal canal stenosis. There is mild right neural foraminal stenosis. Left neural foramen is patent. L5-S1: Minimal disc bulge. No spinal canal stenosis. Minimal narrowing of the neural foramina. Mild bilateral facet arthropathy.Paraspinous soft tissues are within normal limits.
1. Mild degenerative changes in the lumbar spine which have minimally progressed since 9/17/2012. There is no significant spinal canal stenosis at any level. Mild neural foraminal narrowing as above, relatively worse at the right L3-L4 level.2. Moderate facet arthropathy L4-L5 with grade 1 anterolisthesis, similar to prior.3. Fibrofatty infiltration of the filum terminale with normal conus position. This finding may be seen as a normal variant.