History of large left-sided disc herniation with low back pain and neurogenic claudication. Evaluate for resolution of herniation and nerve compression. There is redemonstration of moderate dextroscoliosis of the lumbar spine. There is unchanged mild anterolisthesis of L4 relative to L5.Marked degenerative endplate irregularity and signal alteration is demonstrated from L3-4 through L5-S1. No additional concerning marrow signal alteration is seen. Except for degenerative endplate deformation, the vertebral bodies show normal morphology. L1-2: Bilateral facet hypertrophy. Ligamentum flavum thickening. Mild bulging disk. No spinal canal stenosis. Moderate left and mild right foraminal narrowing. L2-3: Left greater than right facet hypertrophy. Ligamentum flavum thickening. Bulging disk with resolution of previously identified superimposed left subarticular zone extrusion. Mild generalized spinal canal stenosis. Severe left foraminal and moderate right foraminal narrowing.L3-4: Marked bilateral facet hypertrophy somewhat worse on the left. Ligamentum flavum thickening. Bulging disk and osseous spurring. Moderate generalized spinal canal stenosis. Severe left and moderate to severe right foraminal narrowing. Findings are unchanged. L4-5: Marked bilateral facet hypertrophy. Disk bulging and osseous spurring. Severe generalized spinal stenosis with crowding of the nerve roots. Severe right and moderate to severe left foraminal narrowing. Findings are unchanged. L5-S1: Marked facet hypertrophy. Mild bulging disk. No significant generalized canal stenosis though there is some effacement of the right lateral recess. Severe right and moderate to severe left foraminal narrowing. Findings are unchanged. There are small bilateral renal cysts. The left psoas muscle and some of the left posterior paraspinal muscles are partially atrophic.
1. Interval resolution of left L2-3 disk extrusion. There remains mild generalized spinal canal stenosis at this level, with severe left foraminal and moderate right foraminal narrowing.2. Moderate generalized canal stenosis at L3-4 with severe left and moderate to severe right foraminal narrowing, which are unchanged.3. Severe generalized spinal canal stenosis at L4-5 with severe right and moderate to severe left foraminal narrowing, which are unchanged. 4. Severe right and moderate to severe left foraminal narrowing at L5-S1, which are unchanged.