Female, 61 years old, left hip pain. Assess for new herniated disk. Since the prior examination, further compression of the L1 vertebral body has occurred. There is now at least 30% loss of vertebral body height, previously about 15%. Elevated STIR signal within the vertebral body is compatible with edema. The vertebral body is retropulsed to a greater degree than before, and this retropulsion does cause a moderate spinal stenosis and mild impingement of the conus.The remaining vertebral bodies demonstrate preservation of height. There is evidence of degenerative endplate signal change at several levels, but no other areas of concern in marrow replacement or marrow edema are seen. The normal lumbar lordosis is straightened.Except where impinged by the retropulsed vertebral body, the conus and cauda equina are unremarkable.T12-L1: Facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. The L1 vertebral body is retropulsed as above which contributes to a moderate spinal canal stenosis below the level of the T12-L1 disk.L1-2: Facet hypertrophy. No significant spinal canal stenosis. Mild/moderate bilateral foraminal narrowing secondary to L1 compression. No significant interval changes. L2-3: Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. No significant interval changes. L3-4: Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. No significant interval changes. L4-5: Facet hypertrophy and ligamentum flavum thickening. Bulging disk asymmetric to the right with a right subarticular zone annular fissure. Effacement of the right lateral recess. Moderate bilateral foraminal narrowing. No significant interval changes. L5-S1: Facet hypertrophy and ligamentum flavum thickening. Mild bulging disk with a right foraminal/far lateral disk osteophyte complex. No significant spinal canal stenosis. Severe right and mild left neuroforaminal narrowing. No significant interval changes.
1. Progressive collapse of the L1 vertebral body which now shows at least 30% loss of height, previously 15%. There is a greater degree of bony retropulsion which does results in a new mild impingement of the conus.2. Degenerative findings at other levels are not appreciably changed from the prior exam.