Increasing low back pain. Abdominal aortic aneurysm repair with a stent graft one month ago. THORACIC SPINE:Alignment is anatomic. While overall vertebral body height is preserved, there is minimal multilevel endplate concavity in the upper/mid thoracic spine, most pronounced at T7. This is not associated with marrow edema. There are foci of T1/T2-hyperintense signal anteriorly subjacent to the superior and inferior endplates of T7, which can be degenerative in nature or may reflect hemangiomas. Similar but more central signal abnormality in the right side of T12 vertebral body is compatible with a hemangioma. There is no suspicious marrow signal abnormality otherwise. The intervertebral discs show desiccation but relatively preservation of height. The spinal canal is preserved. The thoracic spinal cord shows normal shape and signal characteristics. There is no significant spinal canal or neural foraminal stenosis at all levels. Following contrast administration, there is no abnormal spinal cord, leptomeningeal, or epidural contrast enhancement. The thyroid gland is enlarged. Well-circumscribed, T1/T2-hyperintense, non-contrast-enhancing nodules in the left thyroid lobe may represent colloid cysts. The largest measures 14 mm in diameter.Multilevel degenerative cervical spine spondylosis associated with disc-osteophyte complexes that minimally indent the ventral aspect of the spinal cord without intrinsic spinal cord signal abnormality. These are not completely evaluated on this examination.LUMBOSACRAL SPINE:Alignment is anatomic apart from 2 mm of anterior subluxation of L5 relative to S1, which is probably degenerative in nature. The vertebral bodies are preserved in height. Marrow signal is notable for degenerative change along the inferior L3 and superior S1 endplates. There is also degenerative signal in the right-sided articulating pillars related to the severely osteoarthritic L5-S1 facet. There is partial disc desiccation but heights are fairly preserved. The spinal canal is preserved. The tip of the conus medullaris lies at the mid/lower L1 vertebral level. The conus medullaris shows normal shape and signal. Following contrast administration, there is no abnormal spinal cord, leptomeningeal, epidural or osseous contrast enhancement. T12-L1, L1-L2, and L2-L3: There is no significant disc herniation. There is mild facet arthropathy and ligamenta flava thickening. There is no spinal canal or foraminal stenosis. L3-L4: There is minimal disc bulge and mild facet arthropathy. There is moderate ligamenta flava thickening. There is no significant spinal canal and only mild left foraminal stenosis.L4-L5: There is mild disc bulge along with moderate facet arthropathy and negative flat thickening. There is no significant spinal canal stenosis and only mild right foraminal stenosis.L5-S1: Disc uncovering along with severe, right more than left, facet arthropathy and ligamenta flava thickening result in transverse narrowing of the spinal canal and relative preservation of the anteroposterior diameter. There is mild narrowing of the subarticular recesses and the neural foramina.The endograft through the lower abdominal aortic aneurysm is partially included. There is also severe osteoarthritic changes of the sacroiliac joints with osteophytes and subarticular sclerosis. There is a small, narrow neck umbilical hernia, containing fat but not completely imaged.
1.There are no imaging findings to suggest thoracolumbar spinal infection.2.No significant degenerative disease of the thoracic spine. 3.Thyroid nodules are incompletely assessed on this examination. If further assessment is clinically warranted, thyroid ultrasound can be considered.4.Degenerative disease of the lumbar spine is most pronounced at L5-S1, where severe facet arthropathy and ligamentous thickening result in mild bilateral neural foraminal and subarticular recess stenoses.