Female; 45 years old. Reason: progression of disk herniation History: paresthesias and weakness in L5 dermatome/myotome Grade 1 retrolisthesis of L5 on S1 is again noted, unchanged in extent. Fatty degenerative endplate changes at L4 and L5 are stable. The conus is normal in signal and morphology and terminates at an appropriate level.L1/2: No evidence of neuroforaminal or central canal stenosis, unchanged.L2/3: No evidence of neuroforaminal or central canal stenosis, unchanged.L3/4: Mild ligamentum flavum and facet hypertrophy. No evidence of neuroforaminal or central canal stenosis. These findings are unchanged.L4/5: The disc demonstrates moderately reduced T2 signal with mild loss of disk height. Superimposed on the previously demonstrated moderate disc bulge with slight extrusion upwards is a new right paracentral disc protrusion causing marked right lateral recess stenosis. Mild facet joint hypertrophy and minimal bilateral neural foraminal narrowing is unchanged.L5/S1: The disc demonstrates moderately reduced T2 signal. There is progressive thickening of ventral epidural fat resulting in thecal sac narrowing, but the nerve roots are not crowded. There is a mild disk bulge minimally effacing the ventral CSF space without significant central canal stenosis. Mild facet joint hypertrophy. Mild right greater than left neuroforaminal narrowing. Mild thickening of the ligamentum flavum. These findings are unchanged.
At L4/5 there is a new right paracentral disc protrusion causing marked right lateral recess stenosis. Degenerative changes elsewhere are stable in appearance and described in detail above.