Continued worsening back pain, status post kyphoplasty. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights in the lumbar spine are grossly maintained aside from mild compression deformity involving the superior endplate of L1 which is similar to 4/1/2016 and also evident on CT lumbar spine from 10/6/2015. Schmorl's nodes which are evident throughout the lumbar spine are not appreciably changed since 4/1/2016. Mild bone marrow edema is seen involving the L1 to L3 vertebral bodies which is not significantly changed since 4//2016 and may be related to degenerative change, surgery, and/or Schmorl's nodes. Mild deformity of the superior L5 endplate is also unchanged and may reflect graft subsidence but unchanged since at least 10/6/2015. There is severe lumbar levoscoliosis with apex at the L3-L4 level as seen before with mild right lateral translation of L2 on L3 and left lateral translation of L4 and L5. Partially imaged T10 chronic compression fracture is noted.Individual levels as described below:L1/2: Degenerative disc disease, vacuum disc phenomena, and eccentric left disc bulge including involvement of left neural foramen. Mild right and moderate left neural foraminal stenosis. No central canal stenosis.L2/3: Interbody spacer is present. There is mild disc bulge and facet arthropathy. There is no significant central canal stenosis. There is moderate right and mild left neural foraminal stenosis. L3/4: Interbody spacers present. There is mild disc bulge and facet arthropathy, particularly on the right. Moderate right neural foraminal stenosis. No left neural foraminal or spinal canal stenosis.L4/5: Interbody spacer is present. There is mild disc bulge, and moderate bilateral facet arthropathy. There is no significant central canal stenosis. There is moderate right and mild-to-moderate left neural foraminal stenosis. L5/S1: Minimal degenerative disc disease. No neural foraminal or spinal canal stenosis.
1. No findings to suggest an acute compression fracture.2. Mild L1 compression fracture demonstrates no significant associated edema and not significantly changed since CT from 10/6/2015.3. Multiple Schmorl's nodes throughout the lumbar spine are not significantly changed. 4. Severe levoscoliosis of the lumbar spine again seen. No significant spinal canal stenosis at any level. Multilevel neural foraminal narrowing as described above.