 There is unchanged mild retrolisthesis of L5 on S1 measuring approximately 5 mm. The vertebral body heights are well-maintained. There is disc desiccation of L3-L4, L4-L5 and L5-S1, which is unchanged. There is mild loss of disc height at L3-L4 and L4-L5 and moderate loss of disc height at L5-S1, which are unchanged. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the L1-L2 level. T1 hyperintensity is again present within the filum terminale, which demonstrates signal loss on fat suppression and STIR technique on the 7/21/2014 exam.T12/L1: Bilateral facet degeneration, but no significant disc bulge, spinal canal or foraminal stenosis.L1/2: Bilateral facet degeneration, but no significant disc bulge, spinal canal or foraminal stenosis.L2/3: Bilateral facet degeneration, but no significant disc bulge, spinal canal or foraminal stenosis.L3/4: Mild disc bulge, bilateral facet degeneration and ligamentum flavum thickening, but no significant spinal canal or foraminal stenosis.L4/5: Diffuse disc bulge, bilateral facet degeneration and ligamentum flavum thickening, contributing to mild spinal canal stenosis.L5/S1:Diffuse disc bulge with superimposed left paracentral disc extrusion with inferior migration measuring 7 mm, progressed since prior study, bilateral facet degeneration and ligamentum flavum thickening, contributing to mild to moderate central canal stenosis and effacement of the left lateral recess, and mild right and moderate left foraminal stenosis.
1. Degenerative changes of the lower lumbar spine with new left paracentral disc extrusion at L5/S1 with resulting effacement of the left lateral recess and mild to moderate central spinal canal stenosis. There is mild right and moderate left L5/S1 foraminal stenosis. There may be impingement of the traversing left S1 and exiting left L5 nerve roots at this level. Mild spinal canal stenosis at L4/L5.2. Fatty filum terminale with conus terminating normally at L1-2.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.