Back pain, lumbar radiculopathy. Right back pain and right foot numbness. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is 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. Bilateral facet arthropathy. .L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis. Bilateral facet arthropathy.L3-L4: Mild disc desiccation. No spinal canal or left neural foraminal stenosis. Minimal right neural foraminal narrowing. Bilateral facet arthropathy.L4-L5: There is a small right paracentral extrusion which is again seen with effacement of the right lateral recess and may be impinging on the descending right L5 nerve root. There is moderate degree of central spinal canal stenosis similar to prior. Advanced bilateral facet arthropathy and ligamentum flavum thickening and prominence of the epidural fat all contribute to the central spinal canal stenosis. Prominent right lateral osteophyte contacts and laterally displaces the right L4 nerve root without obvious impingement. There is mild narrowing of the bilateral neural foramina.L5-S1: Disc desiccation. No significant spinal canal or neural foraminal stenosis. Advanced bilateral facet arthropathy.Severe atrophy involving the left iliopsoas muscle is again seen which is nonspecific but may be related to disuse.
Multilevel degenerative changes in the lumbar spine not significantly changed since 3/25/2013. Again noted is a right paracentral disc extrusion at the L4-L5 level which effaces the right lateral recess and suspected to be impinging on the traversing right L5 nerve root. There is also moderate central spinal canal narrowing at this level. Individual levels as detailed above.Advanced bilateral facet arthropathy at L4-L5 and L5-S1 may be contributing to patient's low back pain.