 For purposes of numbering, T12 was again assigned to a level containing a small right hypoplastic rib. With this numbering nomenclature, there is transitional anatomy with sacralization of L5, including pseudoarthrosis on the left. If procedural intervention is contemplated, verification of levels with CT or x-ray before hand is recommended.There has been interval mild (less than 25%) height loss anteriorly in the L1 vertebral body with increased STIR signal in the bone marrow suggesting edema. There is no retropulsion of bony fragments. The conus is normal in signal and morphology and terminates at an appropriate level. Disc desiccation with disc height loss is present from L1-2 through L4-5. Degenerative endplate marrow signal changes are redemonstrated at L4-5, progressed from prior.T12-L1: Mild right facet hypertrophy without stenosis, unchanged.L1-2: Asymmetric bulge to the left which abuts the exiting left L1 nerve root, which is slightly increased in size in the interval. There is also mild bilateral facet hypertrophy. There is no central or significant neural foraminal stenosis. Mild interval worsening of the degenerative disc disease.L2-3: Disc bulge with a new right paracentral disc protrusion narrowing the right subarticular recess, ligamentum flavum thickening, mild to moderate left facet hypertrophy, and moderate right facet hypertrophy. There is moderate right and mild left neural foraminal stenosis. Degenerative changes and stenoses have progressed at this level.L3-4: Minimal anterolisthesis L3 on L4, diffuse mild disc bulge with disc uncovering, ligamentum flavum thickening, and severe bilateral facet hypertrophy. There is mild bilateral subarticular recess and mild bilateral neural foraminal stenosis. These findings are unchanged.L4-5: Asymmetric disc bulge the left, slight ligamentum flavum thickening, moderate left facet hypertrophy, and mild right facet hypertrophy. There is moderate left neural foraminal and mild right neural foraminal stenosis. These findings are unchanged.L5-S1: No disc herniation. No significant spinal canal or neural foraminal stenosis.
1.New, mild compression deformity of the L1 vertebral body with edema suggesting relatively recent occurrence. No retropulsed bony fragments or spinal canal compromise at this level.2.Multilevel moderate lumbar degenerative changes, as detailed above, with mild interval worsening at several levels.