Clinical question: Worsening L4 on L5 the spondylolisthesis? Signs and symptoms: Low back pain with radiculopathy. Nonenhanced lumbar MRI:Lower most visualized thoracic spine and thoracic cord is unremarkable.T12 -- L1 is unremarkable.L1 -- L2 it is unremarkable.L2 -- L3 is unremarkable.L3 -- L4 is unremarkable with the exception of mild degenerative changes.L4 -- L5 demonstrate mild disk desiccation without significant change since prior exam. Minimal grade 1 retrolisthesis remain similar to prior study. Examination demonstrates widening bilateral articulating facets with T2/T2 stir increased signal intensity consistent with bilateral facet inflammatory changes/effusion. This finding demonstrate interval progression since prior exam from 10 -- 7 -- 14. There is no evidence of a spinal stenosis. Moderate to severe bilateral neural foramina compromise is again identified.L5 -- S1 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.
1.No acute findings since prior study.2.Widening of bilateral facet spaces with fluid signal intensity at the L4 -- L5 level with interval worsening since prior exam. Moderate bilateral neural foraminal compromise and without convincing evidence of central spinal stenosis stable since prior exam. Mild grade 1 anterolisthesis also remains stable since prior study.3.Unremarkable images at other levels and without evidence of spinal stenosis or neural foraminal compromise.