Diagnosis: Low back pain. Sciatica, unspecified sideClinical question: low back and bilateral leg painSigns and Symptoms: low back and bilateral leg painClinical question: altered gait, suspect cervical stenosisSigns and Symptoms: altered gait neck pain Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. The patient is status post laminectomy and T2as well as T2 and T3 posterior fusion with pedicle screws. There is minor anterior subluxation of T2 on T3.Spinal stenosis at T2-3 has resolved since the prior exam.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication present at this levelAt C4-5 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication, loss of disk space height, diffuse disk bulge and posterior ligament hypertrophy. There are small end-plate and uncovertebral osteophytes present at this level. There are endplate osteophytes at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication, loss of disk space height, diffuse disk bulge and posterior ligament hypertrophy. There are small end-plate and uncovertebral osteophytes present at this level. There are endplate osteophytes at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication, loss of disk space height and a minor disk bulge at this level. There are small uncovertebral osteophytes present at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is loss of disk space height, disk dessication, diffuse disk bulge and mild to moderate bilateral facet and ligamentum flavum hypertrophy. There is partial effacement of the fat surrounding the left exiting nerve roots at this level within the neural foramen. These findings are stable compared to the prior exam.At L4-5 there is marked loss of disk space height, disk dessication, diffuse disk bulge and moderate bilateral facet and ligamentum flavum hypertrophy. There is partial effacement of the fat at the lateral recess bilaterally at this level. The fat surrounding the exiting nerve roots within the neural foramen is not effaced. Overall there is moderate spinal stenosis at this level stable compared to the prior exam. These findings are stable compared to the prior exam. End plate reactive changes are present with milder T2 signal hyperintensity when compared to the prior exam.At L3-4 there is disk dessication, mild diffuse disk bulge and mild to moderate ligamentum flavum hypertrophy. There is partial effacement of the fat at the lateral recess bilaterally at this level. The fat surrounding the exiting nerve roots within the neural foramen is not effaced. These findings are stable compared to the prior exam.At L2-3 there is disk dessication, minor diffuse disk bulge and minor ligamentum flavum hypertrophy. There is partial effacement of the fat at the lateral recess bilaterally at this level. The fat surrounding the exiting nerve roots within the neural foramen is not effaced. These findings are stable compared to the prior exam.At L1-2 there is disk dessication and a minor diffuse disk bulge. There is redemonstration of a Schmorl's node at this level. There is partial effacement of the fat at the lateral recess bilaterally at this level. The fat surrounding the exiting nerve roots within the neural foramen is not effaced. These findings are stable compared to the prior exam.
1.There are multilevel degenerative changes present in the lumbar spine worse at L4-5 where there is moderate spinal stenosis present stable since the prior exam. Associated end-plate reactive inflammatory changes have decreased since the prior exam.2.There are degenerative changes present in the cervical spine which are stable compared to the prior exam without significant compromise to the spinal canal or exiting nerve roots.3.Status post upper thoracic spine posterior fusion and laminectomy with resolution of prior spinal stenosis.