Low back and bilateral leg pain, greater to right leg. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is loss of lumbar lordosis. Alignment is otherwise maintained. Multilevel degenerative changes are again seen including severe disc height loss of L4-L5 and to a lesser degree L3-L4 and L5-S1 levels. Compared to prior, there appears to be slight worsening of the L3-L4 height loss with increased endplate marrow signal changes. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described by level below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge with small right foraminal disc protrusion. There is no significant spinal canal or neural foraminal stenosis.L3-L4: Mild progression of disc height loss and endplate changes as described above. Mild facet arthropathy and ligamentum flavum thickening. There is mild disc bulge. There is mild neural foraminal narrowing, left relatively worse than right but without clear impingement. Minimal spinal canal narrowing as before.L4-L5: Severe loss of disc height as before. Mild facet arthropathy and ligamentum flavum thickening. There is a mild disc bulge, eccentric to the left. There is no significant spinal canal narrowing. Disc bulge contacts the left L4 nerve root. There is mild to moderate narrowing of the neural foramina, left worse than right. There is also mild encroachment of the right lateral recess.L5-S1: Mild disc height loss and disc bulge with mild facet arthropathy and ligamentum flavum thickening. Suggestion of increased vacuum phenomena or mineralization in the disc compared to prior. No spinal canal stenosis. There is moderate right neural foraminal stenosis where there may be impingement of the right L5 nerve root, similar to prior. There is mild left neural foraminal narrowing.
Multilevel degenerative changes in the lumbar spine appear minimally progressed since prior MRI from 3/19/2015. There is no significant spinal canal stenosis at any level. There is up to moderate right L5-S1 neural foraminal stenosis where there may be impingement of the right L5 nerve root. Left-sided neural foraminal stenosis is relatively worse at the L4-L5 level.