Female, 67 years old, with history of L1 compression fracture. Evaluate for resolution or progression. Since the prior examination, further collapse of the L1 vertebral body has occurred. There is now approximately 60-70% loss of vertebral body height centrally. Elevated STIR signal within the L1 marrow space persists compatible with edema. The degree of retropulsion and associated ventral thecal sac effacement have progressed only minimally if at all. The conus is deflected posteriorly, but does not appear to be frankly impinged as there remains a thin cushion of CSF along its posterior surface.The remaining vertebral bodies demonstrate preserved height. No worrisome marrow abnormalities are detected. A grade 1/2 anterolisthesis of L4 relative to L5 seems to have progressed slightly from the prior examination now measuring up to 8 mm, previously 6 mm. There has been slight progression in the focal kyphotic angulation of the spine centered at L1 as well.T12-L1: L1 vertebral body retropulsion results in a mild to moderate generalized spinal canal stenosis but without frank impingement of the conus. The left neural foramen is mildly narrowed. No significant changes. L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Minimal laterally bulging disc. No significant spinal canal stenosis or neuroforaminal narrowing. No significant interval changes.L3-4: Minimal laterally bulging disc. No significant spinal canal or neuroforaminal stenosis. No significant interval changes.L4-5: Advanced facet degeneration with ligamentum flavum thickening. Disc bulging and disc uncovering with a superimposed right paracentral superiorly directed extrusion. Severe narrowing of the spinal canal with crowding and likely impingement of the cauda equina nerve roots. Moderate to severe right and mild left neuroforaminal narrowing. No interval changes. L5-S1: Advanced left and mild right facet degeneration. No significant spinal canal or neuroforaminal stenosis. No interval changes.
1.Further interval collapse of the L1 vertebral body. Associated retropulsion and ventral thecal sac effacement are minimally changed if at all. This results in a moderate generalized spinal canal stenosis. The conus is deflected posteriorly but not frankly impinged.2.A grade 1/2 anterolisthesis of L4 relative to L5 has increased from prior, though this could represent differences in positioning. Degenerative findings at this level, including facet arthropathy, disc bulging and a right paracentral extrusion, have not significantly changed. The spinal canal is severely narrowed with crowding and impingement of the cauda equina similar to prior.