51-year-old male with radicular pain in the left lower extremity, assess for left lumbar radiculopathy. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. There is mild fibrofatty infiltration of the filum terminale measuring 1-2 mm in thickness which can be a normal variant. Paraspinous soft tissues are within normal limits.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. Mild facet arthropathy. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. Mild facet arthropathy. No spinal canal or neural foraminal stenosis.L3-L4: Minimal disc bulge and bilateral facet arthropathy. There is mild spinal stenosis which appears slightly worse related to increased prominence of the epidural fat when compared to the prior exam. There is mild left and minimal right neural stenosis.L4-L5: Moderate degree of fatty endplate marrow signal changes is similar to prior. There is mild disc bulge, facet arthropathy, ligamentum flavum thickening, and prominence of the epidural fat. There is mild to moderate spinal canal stenosis, minimally worse since prior. There is partial effacement of the lateral recesses. There is mild to moderate left greater than right neural foraminal stenosis similar to prior without clear evidence of nerve impingement.L5-S1: There is a mild disc bulge without significant interval change. There appears to be moderate spinal canal stenosis related to increased prominence of the epidural fat as well as the epidural venous plexus which narrows the thecal sac compared to the prior exam. No significant neural foraminal stenosis.
1. Multilevel degenerative changes in the lumbar spine. Compared to 12/22/2010, there is worsening of spinal canal stenosis in the lower lumbar spine primarily related to increased prominence of the epidural fat which circumferentially narrows the thecal sac; from L4-5 to L5-S1 there is up to moderate spinal canal stenosis.2. At L4-L5 there is mild to moderate left relatively greater than right neural foraminal stenosis, which is similar to prior. No high grade neural foraminal stenosis at any level. 