75 years Female (DOB:11/22/1940)Reason: low back pain with left sided sciatica History: as abovePROVIDER/ATTENDING NAME: KAMALA GULLAPALLI COTTS KAMALA GULLAPALLI COTTS Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment . There is a superior endplate compression at L4 which was also present on the prior exam, however, it appears to have mildly progressed in the Schmorl's node at the superior endplate of L4 is larger on the current exam. There is a inferior endplate compression at L3 which is new since the 10/6/2007 exam. T2 signal hyperintensity with within the inferior half of the L3 vertebral body suggests acute or subacute compression. There is a compression fracture present at T12 with 50% loss of vertebral body height. This appears to be chronic and unchanged since the 10/6/2007 exam. There is mild kyphotic deformity at this level. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is disc desiccation and broad-based right far lateral disc protrusion at this level which extends into the right neural foramen and encroaches the exiting nerve roots within the neural foramen. There is some ligamentum flavum hypertrophy at this level. These findings were also present on the prior exam but have mildly progressed.At L4-5 there is a disc bulge associated with ligament flavum hypertrophy and facet hypertrophy. There is narrowing of the spinal canal at this level with mild degree of spinal stenosis. These findings were also present on the prior exam but have mildly progressed.At L3-4 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with some ligamentum flavum hypertrophy, effacement of the fat at the lateral recesses and crowding of the nerve roots. Overall there is moderate spinal stenosis at this level. This hasn't significantly progressed since the prior examAt L2-3 there is no significant compromise to spinal canal or neural foramina. There is disc desiccation, Schmorl's node and a diffuse disc bulge at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is mild loss of disc space height and a diffuse disc bulge at this level.
1.Since the previous examination the patient has developed a new subacute compression at the inferior endplate of L3. There is redemonstration of a compression fracture at T12 which is stable and some mild progression of the superior endplate of L4 compression fracture.2.Since the prior exam, the patient has developed a moderate degree of spinal stenosis at the L3-4 level.3.There are multilevel degenerative changes present in the lumbar spine.