Female 64 years old Reason: worsening lumbar radiculitis History: low back pain, radiculitis, numbness legs There is a rightward curve of lumbar spine. There is grade 1 anterolisthesis of L4 on L5, more prominent compared to prior exam. Vertebral body heights are preserved. There are endplate degenerative signal changes at L4-5. No suspicious osseous lesions. There is advanced facet arthropathy at L4-5, with progressive disc disease and significant disc loss of height at L4-5. The conus medullaris terminates appears unremarkable and at L1-2. There is again narrowing of the distal lumbar spinal canal predominantly due to shortened pedicles.T12-L1: Mild diffuse disc bulge without stenosis, similar to prior exam.L1-L2: Mild disc bulge, with small left paracentral protrusion, and with mild right and mild to moderate left femoral narrowing, similar to prior exam. No spinal canal stenosis.L2-L3: No significant foraminal or spinal canal narrowing.L3-L4: Diffuse disc bulge, similar to from prior exam. Mild developmental narrowing of the lumbar canal with mild spinal canal stenosis, similar to prior exam. There is effacement of the left lateral recess. Mild right and moderate left foraminal narrowing, similar to prior exam.L4-5: Progressive disc height loss. There is diffuse disc bulge, eccentric to the left side with new right extrusion with effacement of the right lateral recess. There is moderate to severe spinal canal stenosis, increased from prior exam. There is moderate right and moderate to severe left foraminal narrowing.L5-S1: Disc height loss similar to prior. Disc bulge with bilateral facet arthropathy with mild spinal canal stenosis. There is partial effacement of lateral recesses and moderate to severe bilateral foraminal narrowing.
1.Compared to 2/9/2015, there has been progression of multilevel degenerative changes, particularly at L4-5 with moderate to severe spinal canal stenosis and new right paracentral disc extrusion with superior migration. Moderate to severe neural foraminal narrowing at L4-5 and moderate to severe neural foraminal narrowing at L5-S1 also seen as detailed above.2.Grade 1 anterolisthesis of L4-5, more prominent compared to prior exam. There is also advanced facet arthropathy at L4-5 with increased fluid distention compared to prior exam. Consider dynamic radiographs to assess for stability.