Bilateral lower extremity neurogenic claudication Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.There is development of narrowing of the lumbar spinal canal with superimposed mild degenerative changes as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge, ligamentum flavum thickening, and facet arthropathy contribute to mild spinal canal stenosis. Minimal narrowing of the neural foramina.L3-L4: There is a left paracentral disc protrusion with effacement of the left lateral recess, new since prior MRI from 11/26/2013. There is also moderate degree of central spinal canal stenosis. There is facet arthropathy bilaterally with mild surrounding inflammatory changes in the left. There is moderate to severe left and moderate right neural foraminal stenosis. L4-L5: Small left paracentral annular fissure and minimal protrusion which is minimally more prominent in the interval. Mild effacement of the left lateral recess. Otherwise no significant central spinal canal stenosis. There is bilateral facet arthropathy. Mild bilateral neural foraminal stenosis.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.Paraspinous soft tissues are within normal limits. Degenerative changes are evident at the bilateral sacroiliac joints.
Developmental narrowing of the lumbar spinal canal with superimposed degenerative changes resulting in moderate central spinal canal stenosis at L3-L4 again seen. Compared to 11/26/2013, there is a new left paracentral disc protrusion at the L3-L4 level with severe effacement of the left lateral recess. There is also moderate to severe left and moderate right neural foraminal stenosis at the L3-L4 level. There is also mild spinal canal stenosis at L2-L3. Additional details as above.