72 years Male (DOB:12/27/1943)Reason: Known L3 L4 compression, worsening symptoms History: as abovePROVIDER/ATTENDING NAME: RITA M ROSSI-FOULKES RITA M ROSSI-FOULKES Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and diffuse disc bulge at this level. Disc material abuts the nerve root at the left lateral recess at this level, however, the exiting nerve root as a fat pad behind it.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and diffuse disc bulge at this level.At L3-4 there is loss of disc space height, desiccation and a disc bulge associated with the left paramedian disc protrusion which abuts the nerve root at the left lateral recess and mildly encroaches on the nerve root at the left lateral recess. This encroachment of the nerve root at the left lateral recesses developed since the prior exam. There is also some facet and ligamentum flavum hypertrophy at this level.At L2-3 there is loss of disc space height, disc desiccation, disc bulge, endplate reactive changes and bilateral facet hypertrophy. Facet hypertrophy is greater on the right side versus the left side. There is a encroachment of the thecal sac at this level with obliteration of the spinal fluid surrounding the nerve roots at this level. Overall there is a moderate to marked degree of spinal stenosis at this level. This appearance was also present on the prior exam and has not changed significantly. There is narrowing of the right neural foramen at this level with some encroachment of the right-sided exiting nerve root within the neural foramen.At L1-2 there is no significant compromise to spinal canal or neural foramina.
There are multilevel degenerative changes present in the lumbar spine worse at L2-3 where there is moderate to severe spinal stenosis and encroachment of the right-sided exiting nerve roots. This is stable compared to the previous exam from 2015.