Persistent sciatica, left-sided Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is minimal retrolisthesis of L2 on L3 and L3 on L4. Alignment is otherwise within normal limits. Bone marrow signal is benign with T1 hyperintense focus at the L4 vertebral body compatible with hemangioma. Mild edematous changes are evident involving the left aspect of the L5-S1 endplates. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge and bilateral facet arthropathy. No spinal canal or neural foraminal stenosis.L3-L4: Mild disc bulge and mild facet arthropathy. There is associated mild right-sided neural foraminal stenosis. No spinal canal or left neural foraminal stenosis.L4-L5: Mild disc bulge with small right paracentral annular fissure. There is moderate bilateral facet arthropathy and ligamentum flavum thickening. There is effacement of the right lateral recess as well as mild bilateral, right greater than left, neural foraminal stenosis. There is also fairly mild central spinal canal stenosis. These findings are progressed since 8/28/2009.L5-S1: There is moderate disc height loss at this level with suggestion of vacuum phenomena. There is mild disc bulge which is eccentric to the left with a left foraminal component. There is mild right and mild to moderate left neural foraminal stenosis. There is contact of the left L5 nerve root. These findings are progressed since 8/28/2009.Paraspinous soft tissues are within normal limits.
Mild progression of multilevel degenerative changes compared to 8/28/2009, which are relatively worse at the L4-L5 and L5-S1 levels. 