Male, 79 years old, with left lower back pain. Evaluate for lumbar spine/sacroiliac disease. A moderate compression deformity of the T12 vertebral body with evidence of prior kyphoplasty is redemonstrated without significant interval change. The remaining vertebral bodies demonstrate preservation of height. Straightening of the cervical lordosis is seen. Endplate degenerative marrow signal is seen at L4-5, worse than on the prior examination, and to a lesser degree at L3-4, improved from prior.The visualized distal spinal cord, conus and cauda equina are within normal limits. No epidural abnormalities are suspected.L1-2: Loss of disc T2 signal but relative preservation of disc height. No significant spinal canal or foraminal stenosis. L2-3: Facet arthropathy and ligamentum flavum thickening. Loss of disc T2 signal but relative preservation of disc height. Mild predominantly lateral disc bulging. No significant generalized spinal canal stenosis. Mild bilateral foraminal narrowing. Findings have slightly progressed from prior. L3-4: Facet arthropathy and ligamentum flavum thickening. Mild loss of disc height and disc bulging. A previously seen left paracentral/foraminal protrusion is less conspicuous, but bilateral lateral bulging results in effacement of both lateral recesses and moderately severe narrowing of the neural foramina. These findings have progressed from prior. There is also a moderate generalized spinal canal narrowing. L4-5: Facet arthropathy and ligamentum flavum thickening. Bulging disc. Moderate to severe spinal canal narrowing with crowding of the cauda equina. Severe left foraminal narrowing with likely nerve impingement. Moderate to severe right foraminal narrowing. Findings have progressed from prior. L5-S1: Facet arthropathy and ligamentum flavum thickening. Bulging disc with a right paracentral protrusion. No significant generalized spinal canal stenosis. Severe right and moderate to severe left foraminal narrowing. Findings have progressed from prior. Sclerosis and osteophyte formation at the sacroiliac joints is partially visualized on this examination.
Disc and posterior element degeneration has progressed at multiple levels. At L3-4, this results in moderate generalized spinal canal stenosis and moderate left foraminal narrowing. At L4-5, this results in a moderate to severe spinal canal stenosis, severe left and moderate to severe right foraminal narrowing.