Reason: Evaluate for cord compression, disc disease, nerve root compression. New onset left leg pain Alignment is within normal limits. There is multilevel lumbar spondylosis most severely affecting L4-5, with level specific findings as described below. The imaged portions of the distal cord are normal in signal and caliber. There is some redundancy of the cauda equina which is unchanged. Multiple renal cysts are partially imaged. Additional level specific findings are as follows: T12-L1: No significant degenerative disk disease, central canal, or neuroforaminal stenosis. L1-L2: No significant degenerative disk disease, central canal, or neuroforaminal stenosis. L2-L3: No significant degenerative disk disease, central canal, or neuroforaminal stenosis. Mild hypertrophic facet degenerative changes. L3-L4: Mild disk bulge without significant central canal, or neuroforaminal stenosis. Moderate hypertrophic facet degenerative changes. L4-L5: The right paracentral disk protrusion seen on 5/2012 is decreased, with improved central canal stenosis which is now moderate. However, the degree of disk space narrowing has increased, with new extruded foraminal components. These along with moderate facet degenerative changes result in moderate-severe right and severe left neuroforaminal stenosis, increased since 2012. L5-S1: Minimal degenerative changes with minimal narrowing of both neural foramina and no significant central stenosis.
1. Severe degenerative disk disease at L4-L5. The degree of disk space narrowing has increased, with new extruded foraminal components resulting in moderate-severe right and severe left neuroforaminal stenosis which has progressed since 2012. The right paracental disk protrusion seen on the prior study has somewhat improved, now with moderate central stenosis. 2. Mild degenerative spondylosis affecting L3-L4 and multilevel facet degenerative changes otherwise appear similar to the 2012 study. 