Male, 75 years old, with neurogenic claudication. Spinal alignment is anatomic. Marrow signal characteristics are somewhat heterogeneous which may represent the presence of asymmetric fat or benign hemangiomas. Scattered Schmorl's node deformities are also demonstrated appearing similar to the prior examination. Vertebral body height and morphology are otherwise unremarkable. No worrisome marrow replacement or evidence of marrow edema is seen. The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No epidural abnormalities are suspected. Cystlike renal lesions are redemonstrated bilaterally. The right psoas muscle is smaller than the left.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Facet arthropathy is similar to prior, with a lobular cystic structure projecting dorsally from the left facet joint likely representing a synovial cyst. Disc bulging slightly asymmetric to the right is unchanged. No significant generalized spinal canal stenosis is seen. Mild bilateral foraminal narrowing is unchanged. L3-4: Facet arthropathy and ligamentum flavum thickening. Disc bulging. Mild narrowing of the spinal canal. Moderate right and mild left foraminal narrowing. Findings are unchanged. L4-5: Facet arthropathy and ligamentum flavum thickening. Disc bulging with a right foraminal protrusion. Moderate generalized spinal canal narrowing. Severe right foraminal narrowing with probable nerve root impingement. Mild left foraminal narrowing. Findings are unchanged. L5-S1: Facet arthropathy. Disc bulging asymmetric to the right foraminal zone. Mild generalized spinal canal narrowing. Moderate to severe right foraminal narrowing. A previously seen cystic structure in the right neural foramen is no longer identified. Findings are otherwise unchanged.
No significant interval change is seen in multilevel disc and posterior element degeneration. Most notably, there remains severe foraminal narrowing on the right at L4-5 with possible nerve root impingement.