Female, 82 years old, with known degenerative disc disease, left lower extremity sural neuropathy, and sciatica, narrowing on last MRI one year ago. Presenting with progressive left lower extremity pain over the past two weeks. Grade 1 anterolisthesis of L4 relative to L5 is unchanged. Sagittal alignment is otherwise unremarkable. Vertebral body heights are preserved. No concerning marrow replacement is seen. Degenerative endplate signal change is noted at L5-S1.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable except as discussed by level below.Partially imaged disc bulging and disc protrusions in the lower thoracic spine show no significant interval change. Again seen is generalized loss of disc T2 signal in the lumbar spine with loss of disc height most notably at L5-S1, unchanged. Additional level specific findings are as follows:L1-2: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. No interval changes. L2-3: Moderate facet hypertrophy and ligamentum flavum thickening. Mild bulging disc. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. No significant interval changes. L3-4: Moderate facet hypertrophy and significant ligamentum flavum thickening. Moderate bulging disc. Moderate generalized spinal canal stenosis with slight crowding of the cauda equina. Mild bilateral foraminal narrowing. No significant interval changes. L4-5: Marked facet hypertrophy and ligamentum flavum thickening. Disk bulging and disc uncovering. Severe generalized spinal canal stenosis with crowding and impingement of the cauda equina nerve roots. Mild bilateral foraminal narrowing. No interval changes. L5-S1: Marked facet hypertrophy and ligamentum flavum thickening. Bulging disc and osteophytic spurring. Moderate generalized spinal canal stenosis with particular effacement of the lateral recesses and likely impingement of the transiting S1 nerve roots. Moderate bilateral foraminal narrowing. No interval changes. Incidental note is again made of a staghorn calculus within the left renal collecting system. The right kidney is atrophic and contains at least one cyst.
No significant interval change in multilevel degenerative disease is seen when compared to the prior examination from 2014. Significant spinal canal stenosis is seen at L3-4, L4-5 and L5-S1 with moderate bilateral foraminal narrowing at L5-S1.