71 year old female with low back pain and altered gait, assess for stenosis LUMBAR SPINE:Alignment is anatomic. Level disk desiccation. Vertebral body heights are intact. No abnormal signal within the distal cord with the conus, ending at L2-L3. T12-L1: No central or neuroforaminal stenosis.L1-L2: No central or neuroforaminal stenosis.L2-L3: Mild facet arthropathy and ligamentum flavum thickening. No central or neuroforaminal stenosis.L3-L4: Mild facet arthropathy and ligamentum flavum thickening. No central or neuroforaminal stenosis.L4-L5: Diffuse disk bulge is unchanged. Moderate facet arthropathy and effusions are increased. Mild ligamentum flavum thickening with a new 6-mm synovial cyst in the left lateral recess (12/20). Moderate central canal stenosis is slightly increased. Severe right neural foraminal stenosis is increased. Mild left foraminal stenosis is unchanged.L5-S1: Diffuse disk bulge, mild facet arthropathy and ligamentum flavum thickening is unchanged. Mild central canal stenosis is unchanged. Severe left and moderate to severe right neuroforaminal stenosis is unchanged.CERVICAL SPINE:There is straightening of the cervical spine with minimal grade 1 retrolisthesis of C4 on C5. There are multi-level end plate degenerative marrow signal changes and disk desiccation. Vertebral body heights are intact. There is increased T2 signal within the cord at C4 and C5 where there is thinning of the cord, likely reflecting myelomalacia. There are postsurgical changes of laminectomies involving C3 through C6C2-C3: No spinal or neuroforaminal stenosisC3-C4: Mild posterior disk osteophyte complex. Mild bilateral neuroforaminal stenosis, unchanged. No significant spinal stenosis.C4-C5: Posterior disk osteophyte complex. No significant central canal stenosis. Moderate bilateral neuroforaminal stenosis, unchanged.C5-C6: Central posterior disk osteophyte complex without significant central canal stenosis. Moderate left and mild right more neuroforaminal stenosis, unchanged.C6-C7: Posterior disk osteophyte complex. No central canal stenosis. Moderate left neuroforaminal stenosis, unchanged.C7-T1: Posterior disk osteophyte complex is increased. Mild left neuroforaminal stenosis.
1.Spondylosis of the lower lumbar spine, most severe at L4-L5 and L5-S1, with increased facet arthropathy, right neuroforaminal stenosis, central canal stenosis and a new left lateral recess synovial cyst at the L4-L5 level.2.Postsurgical changes and multilevel neuroforaminal stenosis are mostly unchanged with slight increase in posterior disk osteophyte complex at C7-T1 without associated significant canal narrowing.