Low back pain Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits aside from minimal retrolisthesis of L4 on L5 which is unchanged. Bone marrow signal is benign with small T1 hyperintense focus at the left superior T12 level compatible with a focus of fat or hemangioma. The conus medullaris is at the lower limits of normal in position at the inferior L2 level as before.There is developmental narrowing of the mid to lower lumbar spinal canal with superimposed mild degenerative changes. There is disc desiccation at the L4-L5 and L5-S1 levels, mildly worse at L4-L5 compared to prior from 1/20/2014. Individual levels as below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: Mild disc bulge, facet arthropathy, and ligamentum flavum thickening. There is mild central spinal canal stenosis as before. There is mild left-sided neural foraminal stenosis which appears slightly worse in the interval. Right neural foramen is patent.L4-L5: There is slight worsening of disc bulge at this level with small central protrusion component. Bilateral facet arthropathy and ligamentum flavum thickening again seen. There is moderate spinal canal stenosis which appears slightly worse. There is mild bilateral neural foraminal stenosis, left slightly worse than right. There is mild distention of the facet joints which has increased since prior.L5-S1: There is minimal disc bulge, mild facet arthropathy, and ligamentum flavum thickening with mild effacement of the lateral recesses sees similar to prior. No significant central canal stenosis. There is mild left and minimal right neural foraminal stenosis. Paraspinous soft tissues are within normal limits.
1. Mild progression of degenerative changes in the lumbar spine compared to 1/20/2014. There is up to moderate spinal canal stenosis at the L4-L5 level which has slightly progressed, related to increase in disc bulge and mild progression of facet arthropathy superimposed on a developmentally narrow lumbar spinal canal. 2. Fairly mild multilevel neural foraminal stenoses as detailed above.