Lumbar stenosis Five lumbar type vertebral bodies are presumed to be present with hypoplastic ribs at T12 and partial sacralization of L5, where the right L5 transverse process articulates with the sacrum. Vertebral body heights are within normal limits. There is levoscoliosis of the lumbar spine with with apex at the L3 level. There is also grade 1 anterolisthesis of L3 on L4 which appears more conspicuous than on prior exam. Bone marrow signal is benign. The conus medullaris is normal in position. Multilevel degenerative changes are seen with multilevel disc desiccation stable to minimally worse since 6/3/2014. There is increase in edema involving the anterior superior corner of the L4 vertebral body and present to a mild degree previously. Individual levels as described below:L1-L2: There is minimal disc bulge, ligamentum flavum thickening, and bilateral facet arthropathy. There is minimal narrowing of the spinal canal and neural foramina.L2-L3: Minimal disc bulge, ligamentum flavum thickening and bilateral facet arthropathy. There is no significant spinal canal or neural foraminal stenosis.L3-L4: There is severe hypertrophic facet arthropathy which along with ligamentum flavum thickening, disc uncovering and minimal disc bulge contributing to moderate to severe spinal canal stenosis. Bilateral facet effusions. There is moderate right and mild to moderate left neural foraminal stenosis which are minimally worse in the interval.L4-L5: Disc bulge extending to the right. There is also mild bilateral facet arthropathy. There is no significant central spinal canal stenosis. There is partial effacement of the lateral recesses. There is mild bilateral neural foraminal stenosis.L5-S1: Minimal disc bulge. There is bilateral facet arthropathy. No significant spinal canal stenosis. There is mild right and mild to moderate left neural foraminal stenosis.
There are multilevel degenerative changes in the lumbar spine which have overall slightly progressed since 6/3/2014. In particular, there is slight worsening of moderate to severe spinal canal stenosis at L3-L4, where there is also severe facet arthropathy and degenerative grade 1 anterolisthesis. There is also lumbar levoscoliosis as seen on same-day radiographs. Additional details as above.