Female, 75 years old, with new left lower extremity radicular symptoms in the S1 distribution, history of lumbar degenerative disease. A trace retrolisthesis of L5 relative to S1 is unchanged. Sagittal alignment is unremarkable.Mild endplate irregularity and concavity at T11-12 is seen, similar to prior. Vertebral body height is otherwise preserved. No pathologic marrow replacement or marrow edema is identified.The distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No epidural abnormalities are suspected.T10-11 through T12-L1: As assessed on sagittal imaging, there is loss of disc height and mild disc bulging but no significant spinal canal or foraminal stenosis.L1-2: Minimal facet arthropathy. No significant spinal canal or neuroforaminal stenosis. No interval changes. L2-3: Mild facet arthropathy and ligamentum flavum thickening. No significant spinal canal or foraminal stenosis. No interval changes. L3-4: Mild facet arthropathy and ligamentum flavum thickening. Mild disc bulging. Mild generalized spinal canal narrowing. Mild bilateral foraminal narrowing. No interval changes. L4-5: Advanced facet arthropathy, left worse than right, with progressive facet effusion is. There also appears to be a new 5 mm synovial cyst at which may impinge upon the left lateral recess and the descending left L5 nerve root. The right neural foramen is mildly narrowed but the left foramen is patent. L5-S1: Advanced facet arthropathy and ligamentum flavum thickening. Loss of disc height with disc osteophyte formation. Mild generalized spinal canal stenosis. There is some encroachment upon the lateral recesses bilaterally, and it appears that the left S1 nerve may be mildly impinged between the disc osteophyte and facet. Just before the nerve enters the osseous foramen, it demonstrates T2 hyperintensity which could represent edema or perineural cyst formation. Moderate left and mild right foraminal narrowing. These findings are unchanged.
1.Progressive facet arthropathy at L4-5, particularly on the left where there is a new 5 mm synovial cyst which may upon the descending left L5 nerve root.2.A combination of facet arthropathy and disc degeneration result in lateral recess stenosis at L5-S1. On the left, the descending S1 nerve root may be impinged. This finding, however, is relatively unchanged compared to the prior examination.