Spinal stenosis, lumbar region, with neurogenic claudication [724.03] / Thoracic or lumbosacral neuritis or radiculitis, unspecified [724.4], Reason for Study: ^Reason: New HNP? Pt has known lumbar stenosis. History: New onset severe low back pain. For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. Again demonstrated grade 1 spondylolisthesis of L3 on L4 and L4 on L5, no change since prior study scan.There is normal lumbar lordosis. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The conus medullaris terminates at the L1 level. Right upper pole renal cyst, no change since prior scan.Degenerative changes are specified by the intervertebral level as follows: T12-L1: No evidence of neural foraminal narrowing or spinal stenosis.. L1-L2: Diffuse bulging of disc with disc desiccation abuts thecal sac. Minimal spinal canal stenosis, no change since prior scan. L2-L3: Diffuse bulging of disc with bilateral ligamentum flavum thickening causing minimal to mild spinal canal stenosis, disc desiccation, no change since prior scan. L3-L4: Diffuse bulging of disc with bilateral ligamentum flavum thickening causing mild to moderate spinal canal stenosis. In addition, there is a focal bulging toward the left neural foramen and somewhat far laterally which indents left side nerve root. However, all above findings do not show any interval change since prior scan. L4-L5: Diffuse bulging of disc with bilateral ligamentum flavum thickening causing mild to moderate spinal canal stenosis. There is right far lateral broad-based disc protrusion which compresses right side nerve root. No change since prior scan. L5-S1: Diffuse bulging of disc with disc dessication. There focal central disc bulging with broad based disc bulging toward left lateral recess and neural foramen which narrows left side neural foramen, again, no change since prior scan.
1. Diffuse degenerative spondylosis with multifocal disc protrusions and bulging including L34 (left side foraminal and far laterally), L45 (right far lateral) and L5S1 (central and left lateral recess), no change since prior exam.2. Grade 1 spondylolisthesis of L34 on L45 and L45 on L5S1, no change since prior scan.3. No change of right renal cyst.