Severe back pain radiating into leg, question positive SLR on right. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is moderate degree of dextroscoliosis with apex at the L1-L2 level, which has progressed since 3/2/2012 and can be correlated with radiographs. There is also mild retrolisthesis of L1 on L2 and L2 on L3 as well as mild anterolisthesis of L3 on L4 and L5 on S1. There is fusion across the L1-L2 disc space. There is also severe disc height loss at the L4-L5 and L5-S1 levels as well as the left aspect L2-L3 disc space. Degenerative multilevel endplate marrow signal changes are seen particularly at the L2-L3 and L5-S1 levels. Vacuum phenomenon and subchondral cyst formation better seen on CT abdomen from 10/2/2015.. No suspicious osseous lesions. The conus medullaris is normal in position.Individual levels as below: L1-L2: Mild retrolisthesis and disc bulge. No spinal canal stenosis. There is moderate to severe left greater than right neural foraminal stenosis. L2-L3: Mild retrolisthesis and disc bulge. Advanced facet arthropathy, particularly on the left. There is effacement of the left lateral recess. No significant central canal stenosis. Right neural foramen is patent. There is mild to moderate left neural foraminal stenosis. L3-L4: Mild anterolisthesis and asymmetric left sided disc bulge which effaces the left lateral recess and also contributes to moderate left-sided neural foraminal stenosis. There is also moderate central canal stenosis. Minimal right neural foraminal narrowing.L4-L5: There is a right foraminal disc protrusion and facet arthropathy resulting in moderate right neural foraminal stenosis. There is mild left neural foraminal stenosis. No significant central canal stenosis.L5-S1: Mild anterolisthesis and minimal disc bulge. There is no significant central canal stenosis. There is partial effacement of the lateral recesses. There is moderate to severe bilateral neural foraminal stenosis.Fatty atrophic changes are noted in the lower lumbar paraspinous musculature. Spinal soft tissues are otherwise unremarkable.
Advanced degenerative changes throughout the lumbar spine including dextroscoliosis which demonstrates progression when compared to remote lumbar spine MRI study from 3/2/2012. There is up to moderate central canal stenosis at L3-L4 level. There is also significant multilevel neural foraminal stenoses as detailed above.