Low back pain, occasional radicular symptoms down right lower extremity. Pain down right posterior buttock Numbering is performed similar to prior MRI report from 2004 with postoperative changes of spinal fusion from L4 to S1. As numbered, hypoplastic ribs are noted associated with the L1 vertebral body, better seen on recent CT.There is solid osseous fusion involving the posterior elements from L4 through S1 as well as fusion at the L4-L5 and L5-S1 interbody levels.There is mild retrolisthesis of L2 on L3 and L3 on L4 similar to prior. There has been progression of disc height loss at the L3-L4 level compared to 2004 compatible with adjacent segment disease. Disc height loss and endplate changes at the L2-L3 level have also progressed. There is marrow edema involving the endplates from L2 to L4. Vacuum phenomena is evident at the L1-L2, L2-L3, and L3-L4 levels. Bone marrow signal is benign without suspicious osseous lesions evident. Vertebral body heights are maintained. The conus medullaris is normal in position.Individual levels further described below:L1-L2: Mild disc bulge, ligamentum flavum thickening, and facet arthropathy. There is minimal narrowing of the spinal canal and minimal narrowing of the neural foramina. L2-L3: There is disc bulge and prominent ligamentum flavum thickening and facet arthropathy. There is moderate spinal canal stenosis as well as severe right neural foraminal stenosis. There is mild left neural foraminal stenosis. These findings have significantly progressed since prior 2004 MRI.L3-L4: There is retrolisthesis with endplate osteophyte and advanced bilateral facet arthropathy which contributes to moderate narrowing of the lateral aspect the spinal canal grossly similar to prior. There is up to moderate narrowing of the bilateral neural foramina similar to prior.L4-L5: No spinal canal stenosis. There is mild right and minimal left neural foraminal narrowing. L5-S1: No spinal canal stenosis. There is mild to moderate right and mild left neural foraminal narrowing.
1. Postsurgical changes of spinal fusion from L4 to S1 are again seen with intact hardware and evidence of solid osseous fusion better seen on recent CT from 12/18/2015.2. Advanced degenerative changes are seen above the level of the fusion at the L2-L3 and L3-L4 levels with moderate spinal canal stenosis, particularly progressed at the L2-L3 level when compared to remote MRI study from 9/9/2004. There is severe right L2-L3 neural foraminal stenosis and to a lesser degree at additional levels, as detailed above.3. Please note comment about numbering in the findings section above.