Reason: low back pain, history of multiple myeloma History: low back pain 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. Since the prior examination has undergone laminectomies at L4 and L5 as well as posterior fusion using pedicle screws and interconnecting rods at L4-5 and L5-S1.At L5-S1 there is disk desiccation and loss of disk space height. There is a narrowing of the right neural foramen at this level with some encroachment of right-sided exiting nerve roots .At L4-5 there is disk desiccation, mild disk bulge and loss of disk space height. There is a narrowing of the right neural foramen at this level with some encroachment of right-sided exiting nerve roots .At L3-4 there is loss of disk space height, disk desiccation, Schmorl's node and diffuse disk bulge associated with bilateral facet and ligamentum flavum hypertrophy and effacement of the spinal fluid surrounding the nerve roots within the thecal sac. Overall there is a moderate to severe degree of spinal stenosis at this level. This has significantly progressed since the prior exam.At L2-3 there is loss of disk space height, disk desiccation and diffuse disk bulge associated with ligamentum flavum hypertrophy and mild narrowing of the neural foramina . Overall there is a mild degree of progression of the narrowing of the spinal canal at this level when compared to the previous exam. Currently there is a mild degree of spinal stenosis at this level.At L1-2 there is loss of disk space height, and disk desiccation and diffuse disk bulge associated with a Schmorl's node and some mild narrowing of the neural foramina. Overall there is no significant change since the prior examA cystic lesion is present along the right kidney which is not entirely imaged on this exam but was present on the prior exam as well
1.Since the prior exam the patient has undergone laminectomy and fusion in the lower lumbar spine.2.Since the prior exam the patient has developed a moderate to severe degree of spinal stenosis at L3-4.