35-year-old male with low back pain. History of previous surgery. There is straightening of the normal lumbar lordosis. There is deformity of the L4 vertebral body with associated superior and inferior endplate depression anteriorly consistent with a chronic vertebral body compression fracture, with loss of less than 50% of the vertebral body height. There is grade 1 retrolisthesis of L4 with respect to L5 with increased T1 signal abnormality affecting the superior and inferior endplates of the L4 vertebral body consistent with type II Modic changes. Additionally, there is endplate irregularity along the inferior endplate of L3. These findings are stable.There is otherwise no abnormal bone marrow signal noted. Note is again made of postoperative changes of prior L4/L5 laminectomy with associated expansion of the thecal sac in the surrounding area. The vertebral bodies are otherwise of normal configuration, size and signal. The spinal cord terminates at L1. The inferior portion of the spinal cord, conus and the cauda equina show no signal abnormality. The visualized portions of the lower thoracic spine are unremarkable. L1-2: Normal intervertebral disk height. There is mild intravertebral disk desiccation. No significant central spinal canal or neuroforaminal stenosis. These findings are unchanged. L2-3: There is mild intervertebral disk space narrowing. There is mild facet joint arthropathy and ligamentum flavum hypertrophy. There is no significant central spinal or neuroforaminal stenosis. These findings are unchanged. L3-4: There is advanced degenerative disk disease with intravertebral disk height loss and desiccation. There is no significant central spinal canal or neuroforaminal stenosis. These findings are unchanged. L4-5: There is intervertebral disk space narrowing as well as disk desiccation. There is no significant central spinal canal stenosis. There is a diffuse disk bulge with associated mild bilateral neuroforaminal stenosis, left greater than right. These findings are unchanged.L5-S1: There is mild degenerative disk disease with intervertebral disk space narrowing and disk desiccation. There is mild ligamentum flavum and facet joint hypertrophy. No significant central spinal canal stenosis. A previously demonstrated left lateral disk extrusion has significantly decreased in size, now resulting in flattening of the left S1 nerve sheath origin (previously displaced and compressed).
1.Persistent deformity of the of the L4 vertebral body suggestive of a prior chronic vertebral body compression fracture. There are associated type II Modic degenerative changes and retrolisthesis of the L4 vertebral body. There is also irregularity of the inferior endplate of L3. These findings are stable.2.L4-5: Mild bilateral neuroforaminal stenosis, left greater than right, unchanged.3.L5-S1: A previously demonstrated left lateral disk extrusion has significantly decreased in size, now resulting in flattening of the left S1 nerve sheath origin (previously displaced and compressed).