Male, 60 years old, with worsening radicular back pain. A scoliotic curvature of the lumbar spine does not seem to have significantly changed from prior. There may be a trace retrolisthesis of L4 relative to L5, also unchanged. Vertebral body height is preserved. No worrisome marrow replacement or evidence of marrow edema is seen.The visualized spinal cord, conus and nerve roots of the cauda equina are unremarkable.Multilevel degenerative disc disease is seen in the lumbar spine. Loss of disc height is most conspicuous at L1-2, L2-3, and L5-S1. Additional level specific findings are as follows:L1-2: Progression of degenerative disc disease with further loss of disc height and disc bulging as well as a larger right paracentral/foraminal disc protrusion. Mild facet hypertrophy is seen. No significant generalized spinal canal stenosis is evident though there is effacement of the right lateral recess. Mild right foraminal narrowing is unchanged. L2-3: Progressive degenerative disc disease with further loss of disc height and disc bulging as well as a new right paracentral/foraminal disc protrusion. This causes effacement of the right lateral recess. Hypertrophy of the right facet has progressed. Overall there is a mild generalized spinal canal stenosis which has progressed. Mild right foraminal narrowing is unchanged. L3-4: Bilateral facet hypertrophy and ligamentum flavum thickening. Mild disc bulging/disc uncovering. Mild generalized spinal canal narrowing, unchanged. No significant foraminal narrowing. L4-5: Bilateral facet hypertrophy, progressed. Findings suggestive of prior surgery with probable laminectomy on the left. Progressive disc bulge with annular fissuring. Mild to moderate generalized spinal canal stenosis not significantly changed from prior. Moderate bilateral foraminal narrowing mildly progressed. L5-S1: Facet hypertrophy. Bulging disc. No significant spinal canal stenosis. Mild to moderate bilateral foraminal narrowing. No significant interval changes.
1.Mild interval progression of degenerative findings at several levels as above.2.No areas of high-grade spinal canal stenosis. The most significantly stenotic level appears to be L4-5 where there is evidence of prior surgery.