Advanced degenerative changes in the lumbar spine with back and leg pain. Evaluate for worsening. There are five lumbar type vertebral bodies. There is severe levoscoliosis of the mid to lower lumbar spine with the apex of curvature at L3. There is 8 mm right lateral translation of L2 on L3 and left lateral translation of L3 on L4. The sagittal alignment remains normal with straightening of the normal lumbar lordosis. The vertebral body heights are well-maintained. There is moderate to severe multilevel disc narrowing in the lumbar spine. The T10-L1 disc heights are maintained. Nonspecific, slight diffuse heterogeneity of the bone marrow signal intensity and a focus of high STIR signal in S1 are unchanged. The conus medullaris terminates at upper L2 level.On sagittal image a left paracentral/foraminal disc protrusion at T11-12 appears unchanged.Multilevel degenerative changes are stable as outlined below.T12-L1: There is ligamentum flavum thickening and bilateral left greater than right facet arthropathy but no significant spinal canal or foraminal narrowing.L1-L2: A mild disc bulge is slightly more prominent on the left. There is bilateral facet arthropathy and ligamentum flavum thickening with mild spinal canal and mild to moderate bilateral foraminal narrowing.L2-L3: Small posterior disc osteophyte complex with mild spinal canal stenosis. There is facet arthropathy on the right and bilateral ligamentum flavum thickening resulting in mild to moderate bilateral foraminal narrowing.L3-L4: Diffuse disc bulge is more prominent on the right with moderate spinal canal stenosis. Mild bilateral facet arthropathy and ligamentum flavum thickening narrows the lateral recesses. There is severe foraminal narrowing on the right.L4-5: Diffuse disc bulge is more prominent on the right with mild to moderate spinal canal stenosis. There is left greater than right facet arthropathy and ligamentum flavum thickening with mild to moderate right and moderate left foraminal narrowing.L5-S1: Mild diffuse posterior disc osteophyte complex slightly more prominent on the left encroaching on the left lateral recess and resulting in mild-to-moderate left foraminal narrowing.
Stable scoliosis and multilevel spondylosis again most severe at L3-4 where there is severe right foraminal narrowing and moderate spinal canal stenosis.