Lumbar spine CT for planning pedicle screw fusion at L4-L5. There is grade 1 anterolisthesis of L4. Vertebral body heights are maintained. Multilevel anterior osteophytes are consistent with osteoarthritis. The caliber of the lumbar spinal canal appears small.At L1/L2, L2/L3, and L3/L4, there is mild diffuse disk bulge and disk space narrowing without significant compromise to the spinal canal or neural foramina. Schmorl's nodes are again identified at the superior endplate of L2 and inferior endplate of L3.At L4/L5 there is grade 1 anterolisthesis of L4. In addition, there is a diffuse disk bulge, subchondral sclerosis, bilateral facet and ligamentum flavum hypertrophy causing moderate to marked central spinal stenosis and bilateral encroachment of the lateral recesses, right greater than left. Neural foraminal narrowing is identified on the right. Synovial cyst identified at this level on the prior MRI is not identified on today's CT.At L5/S1, there is diffuse disk bulge and loss of disk space height without compromise to the central spinal canal or neural foramina.
Degenerative changes most prominent at L4-L5 consisting of a diffuse disk bulge, hypertrophic facet and ligamentum flavum changes, and mild anterolisthesis causing central spinal stenosis, encroachment of bilateral lateral recesses, right greater than left, and neural foramina narrowing on the right. The patient had a synovial cyst demonstrated on the prior exam at L4-5. This exam is not sensitive to detecting synovial cyst.