60 year-old female with left leg weakness and burning in the anterior right thigh. History of lupus with CNS involvement Study slightly limited due to patient motion.There is mild grade 1 retrolisthesis of L5 relative to S1. Otherwise alignment is anatomic. Vertebral body heights are intact. Signal within the distal cord and conus is normal, ending at L2. There is multilevel disk desiccation with severe degenerative disk disease at T10-T11. There is also severe degenerative disk disease at T11-T12 which is slightly worse than the prior exam. There is increased disk space loss at L5-S1 with a right far lateral annular fissure with also appears increased. There is increased STIR signal along the superior endplate of T12 and increased degenerative marrow signal changes. A Schmorl's node is noted along the inferior endplate of T10. There is mildly heterogeneous marrow signal which likely reflects focal fat. There is mild multilevel facet arthropathy. There is mild epidural lipomatosis at L5 and within the sacrum.T10-T11: On sagittal images only, there is a left paracentral disk extrusion extending caudally 8 mm, increased from the prior exam. Mild ligamentum flavum thickening. Mild to moderate central canal stenosis. Moderate bilateral neural foraminal narrowing is unchanged.T11-T12: Diffuse disk bulge with a left paracentral disk extrusion extending 8 mm caudally. Mild central canal stenosis. Moderate right and mild left neural foraminal stenosis is unchanged.T12-L1 through L3-4: Mild ligamentum flavum thickening. No central or neuroforaminal stenosis.L4-L5: Mild diffuse disk bulge. No central or neuroforaminal stenosis.L5-S1: Moderate diffuse disk bulge with superimposed left foraminal protrusion. Severe right and moderate left neural foraminal narrowing is unchanged. There is encroachment on the right lateral recess and the disk also abuts the left descending S1 nerve root. No central spinal canal stenosis.
1.Increased severe degenerative disk disease at T10-T11 with increasing disk extrusion at this level. Moderate bilateral neural foraminal stenosis and mild to moderate central canal stenosis at this level is unchanged2.Severe degenerative disk disease, disk extrusion and neuroforaminal narrowing at T11-T12 is unchanged.3.Increased degenerative disk disease at L5-S1 with stable neuroforaminal narrowing, up to severe in degree on the right.4.Additional mild degenerative changes at other levels are stable.