Worsening back pain Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is minimal anterolisthesis of L4 and L5, which appears slightly worse than prior. Alignment is otherwise within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L2-L3: There is a small right foraminal disc protrusion which is worse since prior from 7/13/2010. There is no significant spinal canal stenosis. There is mild right neural foraminal narrowing. No significant left neural foraminal narrowing. Mild facet arthropathy.L3-L4: There is mild disc bulge which is slightly more prominent than prior with a small central extrusion component. There is no significant spinal canal stenosis. There is mild to moderate bilateral neural foraminal narrowing, relatively worse on the right. Mild facet arthropathy.L4-L5: There is moderate bilateral facet arthropathy, ligamentum flavum thickening, and minimal bulge. Trace anterolisthesis. No significant spinal canal stenosis. There is mild left and minimal right neural foraminal narrowing.L5-S1: There is moderate bilateral facet arthropathy and ligamentum flavum thickening. There is no significant spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
Multilevel degenerative changes which have slightly progressed 7/13/2014. There is no significant spinal canal stenosis at any level. Neural foraminal narrowing is relatively worse at the L3-L4 level where there is mild to moderate stenosis. Again seen is multilevel facet arthropathy, relatively worse at the L4-5 and L5-S1 levels, which may be contributing to patient's back pain but grossly similar to prior.