Female, 66 years old, with low back pain bilateral in the buttocks and hip pain worse on the right. Assess for worsening of lumbar stenosis. A mild levoscoliosis of the lumber spine is demonstrated. A trace retrolisthesis of L2 relative to L3, and a grade 1 anterolisthesis of L4 relative to L5 are unchanged.Findings are seen consistent with posterior spinal fusion from L4 through S1.Endplate irregularity and signal abnormality at L2-3 have progressed moderately. Endplate irregularity at L4-5 and L5-S1 have not changed. Otherwise, no evidence of significant marrow signal abnormality is seen.The visualized spinal cord and conus are within normal limits. Details of the cauda equina will be discussed by level as follows:T12-L1: Left facet hypertrophy. Mild bulging disk. No significant generalized spinal canal stenosis. Mild left foraminal narrowing. No significant interval changes.L1-2: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. No significant generalized spinal canal stenosis. Mild left foraminal narrowing. No significant interval changes.L2-3: Moderate facet hypertrophy and ligamentum flavum thickening. Moderate bulging disk. Superimposed right foraminal and far lateral protrusion, the far lateral component of which has increased in size. Superimposed left paracentral inferiorly directed extrusion which is unchanged. Moderate to severe generalized spinal canal stenosis with crowding of the cauda equina, unchanged. Severe bilateral foraminal narrowing, unchanged. L3-4: Mild facet hypertrophy. Minimal bulging disk. No significant generalized spinal canal stenosis. Moderate bilateral foraminal narrowing. No significant interval changes.L4-5: Moderate facet hypertrophy. Disk uncovering and disk bulging, asymmetric to the right. No significant generalized spinal canal stenosis. Assessment of the foramina is compromised by metallic artifact. Otherwise, no significant interval changes.L5-S1: Facet hypertrophy. Moderate bulging disk with a superimposed right foraminal protrusion. No significant generalized spinal canal stenosis. Assessment of the foramen is somewhat compromised by metallic artifact, but severe bilateral foraminal narrowing is suspected and probably hasn't significantly changed. No other significant interval changes.
1. Redemonstration of postoperative findings compatible with posterior spinal fusion from L4 through S1.2. Progression of endplate degeneration at L2-3. Disk bulging and a superimposed left paracentral extrusion at this level are unchanged. A right far lateral extrusion at this level has increased in size. Moderate to severe generalized spinal canal stenosis and severe bilateral foraminal stenoses are unchanged.3. Degenerative findings at other levels are not significantly changed.