73-year-old man with history of spondylolisthesis. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of L4 on L5 and minimal retrolisthesis of L5 on S1, slightly more prominent at L4-5 than the prior examination. Alignment is otherwise within normal limits. Bone marrow signal is benign with hemangioma at L3. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:T12-L1: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L1-L2: Disc bulge, eccentric to the left. There is mild to moderate left neural foraminal stenosis. There is minimal right neural foraminal stenosis. There is no significant spinal canal stenosis.L2-L3: Disc bulge, eccentric to the left. There is mild to moderate left neural foraminal stenosis and mild right neural foraminal stenosis. There is no significant spinal canal stenosis.L3-L4: Disc bulge. There is facet arthropathy with ligamentum flavum thickening. There is mild bilateral neural foraminal stenosis. There is minimal spinal canal stenosis.L4-L5: There is a significant disc bulge along with bilateral facet joint arthropathy and ligamentum flavum thickening with increased distention of the facet joints since the prior exam. There is moderate bilateral neural foraminal stenosis. There is partial effacement of the lateral recesses and mild to moderate central spinal canal stenosis.L5-S1: There is a disc bulge, eccentric to the left. The thecal sac terminates at this level and there is prominent epidural fat. There is effacement of the lateral recesses and moderate to severe bilateral left greater than right neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
Multilevel degenerative changes in the lumbar spine, minimally progressed from the prior exam. There is moderate to severe bilateral L5-S1 and moderate bilateral L4-L5 neural foraminal stenosis. There is effacement of the lateral recesses at these levels and mild to moderate central spinal canal stenosis at L4-L5.