67-year-old female with lower back pain. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is an exaggerated lumbar lordosis which appears unchanged. Alignment is otherwise within normal limits. There is mild edematous change of the L1 anterosuperior endplate which appears grossly similar to prior. Bone marrow signal is benign. The conus medullaris is normal in position. Paraspinous soft tissues are within normal limits.Multilevel degenerative changes are seen, as described below:T12-L1: Minimal disc bulge without significant spinal canal or neural foraminal stenosis.L1-L2: Minimal disc bulge and mild facet arthropathy without significant spinal canal or neural foraminal stenosis.L2-L3: Mild disc bulge and mild facet arthropathy without significant spinal canal or neural foraminal stenosis.L3-L4: Moderate to severe facet arthropathy, left greater than right, and mild to moderate diffuse disc bulge with superimposed broad-based foraminal disc protrusion on the left leading to mild to moderate left neural foraminal stenosis, which appears slightly less severe than the prior exam. Minimal spinal canal narrowing is present.L4-L5: Mild disc bulge and moderate to severe facet arthropathy causing mild right neural foraminal stenosis and minimal spinal canal narrowing, appearing similar to the prior exam.L5-S1: Severe right and moderate left facet arthropathy is noted. No significant spinal canal or neural foraminal stenosis.Degenerative changes of the bilateral sacroiliac joints are noted.
Overall no significant interval change in multilevel lumbar degenerative disease, with mild to moderate left neural foraminal stenosis at the L3-L4 level and mild right neural foraminal stenosis at the L4-5 level. No high grade spinal stenosis at any level. There is moderate to severe multilevel facet arthropathy which may be contributing to patient's back pain. Additional details as above.