 The last well formed disk space is referred to as L5-S1 consistent with prior examination. There is minimal grade 1 retrolisthesis of L5 on S1 without significant change. Vertebral body heights are preserved. There is disk desiccation seen at multiple levels with loss of disk height at L5-S1, L3-4, and L1-2, similar prior exam. The conus terminates at L1-2 and shows normal caliber and signal. The osseous marrow signal is benign. There are scattered high T1 signal foci in the vertebral bodies likely representing focal fatty deposition versus hemangiomas.T11-12: No disk herniation or spinal stenosis. No significant change.T12-L1: No disk herniation or spinal stenosis. No significant change.L1-2: Disk bulge with superimposed worsening disk extrusion which extends superiorly by 16 mm above the superior endplate of L2, and measures up to 6 mm in maximal thickness, with central annular fissure. No significant spinal canal or neural foraminal stenosis.L2-3: Mild disk bulge, and facet arthrosis with ligamentum flavum thickening causing mild central spinal canal stenosis and no significant neural foraminal stenosis. This is unchanged.L3-4: Diffuse disk bulge with right foraminal and far lateral protrusion, ligamentum flavum thickening and facet arthrosis resulting in moderate to severe central spinal canal stenosis and moderate right and mild left neural foraminal narrowing. This is unchanged.L4-5: Diffuse disk bulge, posterior epidural fat prominence, and moderate bilateral facet arthrosis with ligamentum flavum thickening causing mild bilateral right worse than left neural foraminal stenosis and moderate central spinal canal stenosis. This is unchanged.L5-S1: Right central/paracentral disk protrusion, ligamenta flava thickening and facet hypertrophy resulting in encroachment upon the right subarticular zone. No significant central spinal canal stenosis. Mild to moderate neural foraminal stenosis similar to prior.
Multilevel lumbar spondylosis with interval worsening of disk extrusion at L1-2 and central annular fissure without significant spinal stenosis at this level. Additional levels are not significantly changed since 11/14/2013 including moderate to severe central spinal canal stenosis at L3-L4 and moderate central canal stenosis at L4-5.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.