Low back pain with pseudoclaudication. Evaluate for spinal stenosis. There is Grade 1 anterolisthesis of L3 on L4 measuring approximately 6 mm, previously 5 mm. The vertebral body heights are preserved. There is mild loss of disc height at L3-L4. There is disc desiccation at L2-L3 and L3-L4. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The distal spinal cord and conus are within normal limits with the conus terminating at the L2 level. There are postoperative changes in the lower lumbar spine with posterior soft tissue edema at L3-L4.T12-L1: No significant disc bulge, spinal canal or foraminal stenosis. L1-L2: No significant disc bulge, spinal canal or foraminal stenosis. L2-L3: Progression of disc bulge, posterior epidural fat and bilateral facet degeneration, contributing to mild spinal canal stenosis and moderate right and mild left foraminal stenosis. L3-L4: Status post laminectomy. Grade 1 anterolisthesis of L3 on L4, pseudo disc bulge, and bilateral facet degeneration, contributing to moderate to severe bilateral foraminal stenosis. L4-L5: Status post laminectomy. Bilateral facet degeneration, contributing to unchanged mild right and mild to moderate left foraminal stenosis. No significant spinal canal stenosis.L5-S1: Mild disc bulge with superimposed new central disc protrusion, contributing to mild bilateral foraminal stenosis. No significant spinal canal stenosis.
1. Evidence of remote L3-L4 and L4-L5 laminectomies. 2. Degenerative changes of the lumbar spine with progression of disc bulge and posterior epidural fat at L2-L3, contributing to increased mild spinal canal stenosis and moderate right and mild left foraminal stenosis. 3. Grade I anterolisthesis of L3 on L4, contributing to moderate to severe bilateral foraminal stenosis. 4. Multilevel facet arthropathy which may be contributing to patient's back pain.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.