Female, 55 years old. Reason: is there a cause of the lumbar radiculopathy? History: lumbar radiculopathy For the purposes of numbering, five lumbar type vertebral bodies are presumed to be present. There is unchanged mild retrolisthesis of L5 over S1. Lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are well-maintained. Advanced endplate degenerative changes are seen at L5-S1, similar to prior. Otherwise, bone marrow signal intensity is within normal limits. There is disc desiccation at L2-3 through L5-S1, with severe loss of disc height at L5-S1 and to a lesser degree at L4-5. The conus medullaris on sagittal imaging is grossly intact, terminating at approximately the L1-2 level.L1-L2: There is ligamentum flavum and facet hypertrophy with no significant compromise to spinal canal or neural foramina.L2-L3: There is ligamentum flavum and facet hypertrophy and mild disc bulge with mild bilateral neuroforaminal narrowing and minimal spinal canal stenosis.L3-L4: There is ligamentum flavum and facet hypertrophy and mild disc bulge with mild central canal stenosis and partial effacement of the left lateral recess.L4-5: There is facet hypertrophy and ligamentum flavum hypertrophy as well as disc bulge with superimposed right foraminal and extraforaminal disc protrusion. There is mild central canal stenosis, mild to moderate left neural foraminal narrowing, and severe right neuroforaminal stenosis. There may be impingement on the exiting right L4 nerve root.L5-S1: There is mild retrolisthesis, facet joint hypertrophy, and disc bulge causing moderate to severe left neural foraminal narrowing, moderate right neural foraminal narrowing, and effacement of the left lateral recess. There may be impingement of the exiting left L5 nerve root and the descending left S1 nerve root.
Multilevel degenerative changes throughout the lumbar spine, relatively worse at the L4-5 and L5-S1 levels. There may be impingement of the right L4 nerve root at the L4-5 neural foramen, impingement of the left L5 nerve root at the L5-S1 neural foramen, and impingement of the left S1 nerve root at the L5-S1 lateral recess. These findings are mildly progressed from the prior study dated 02/05/2013.