 The lumbar lordosis is preserved. The bone marrow signal intensity and morphology of the lumbar vertebral columns demonstrate scattered fat deposition in the vertebral bodies. There is no evidence of compression fracture. There is developmental narrowing of the lower lumbar spine from L1 to L5. The spinal cord below T11 demonstrate normal signal intensity and caliber. The conus medullaris is normal at the L1 level. Decreased T2 signal intensity is present throughout the lumbar intervertebral disks without disc height change. T12-L1: Shallow posterior central disk protrusion with no mass effect on the central canal. Bilateral neural foramen are patent. Unchanged from prior examination. L1 -- 2: There is a diffuse disc bulge with superimposed left paracentral focal protrusion which along with posterior facet and ligamentous hypertrophic degenerative changes causes moderate left lateral recess and neuroforaminal stenosis as well as mild central spinal stenosis, slightly worsened since prior examination. L2 -- 3: There is a diffuse disc bulge which along with posterior facet/ligamentous hypertrophic degenerative changes and epidural lipomatosis causes moderate to severe spinal stenosis and mild bilateral neural foraminal stenosis, worsened since prior examination. L3 -- 4: There is a diffuse disc bulge at this level which along with posterior facet/ligamentous hypertrophic degenerative changes cause moderate to severe spinal stenosis and mild bilateral neural foraminal narrowing. These findings are unchanged from prior examination. L4 -- 5: There is a diffuse asymmetric leftward disc bulge at this level which along with posterior facet/ligamentous hypertrophic degenerative changes which cause moderate spinal stenosis with moderate left and mild right neuroforaminal narrowing. These findings are similar to prior examination. L5 -- S1: There is a diffuse disc bulge at this level and posterior facet/ligamentous hypertrophic degenerative changes causing mild spinal stenosis and lateral recess stenosis with flattening of the bilateral S1 nerve sheath origins as well as mild bilateral neuroforaminal stenosis. The paraspinal soft tissue is unremarkable.
1.Degenerative disease of the lumbar spine as described above have progressed since 2010.2.Moderate to severe spinal stenosis is demonstrated at L2 -L4 levels predominantly on the basis of degenerative disease with superimposed developmental spinal canal narrowing.3.There is new flattening of bilateral S1 nerve sheaths.