 There is stable grade 1 anterolisthesis of L4 on L5. The vertebral body heights are maintained. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the L1-L2 level. No abnormal postcontrast enhancement is identified.T12-L1: Mild hypertrophic degenerative changes of the ligamentum flavum and posterior facets are demonstrated at this level. Otherwise, no significant abnormalities appreciated at this level. Specifically there is no evidence for disc herniation, neuroforaminal stenosis, or spinal canal stenosis.L1-L2: Mild hypertrophic degenerative changes of the ligamentum flavum and posterior facets are demonstrated at this level. Otherwise, no significant abnormalities appreciated at this level. Specifically there is no evidence for disc herniation, neuroforaminal stenosis, or spinal canal stenosis.L2-L3: Mild hypertrophic degenerative changes of the ligamentum flavum and posterior facets are demonstrated at this level. Otherwise, no significant abnormalities appreciated at this level. Specifically there is no evidence for disc herniation, neuroforaminal stenosis, or spinal canal stenosis.L3-L4: There is intervertebral disc desiccation and a diffuse disc bulge with bilateral ligamentum flavum and facet hypertrophic degenerative changes resulting in mild bilateral neuroforaminal stenosis and mild central spinal stenosis.L4-L5: There is only a small residual low T1 and T2 signal focus posterior to the L4 vertebral body in the epidural space without mass effect, possibly related to scarring. The previously seen lesion in this area likely related to a sequestered disc and is no longer visualized. There is moderate degenerative disc disease and loss of disc height with significant bilateral facet and ligamentum flavum degenerative change and resultant grade one anterolisthesis of L4 over L5. There is moderate left and mild to moderate right neuroforaminal stenosis as well as mild to moderate central spinal stenosis.L5-S1: There is a diffuse disc bulge with superimposed central disc protrusion abutting the bilateral S1 nerve roots. An enhancing small right para-median annular fissure is again visualized. There is mild to moderate left neural foraminal narrowing without right neuroforaminal stenosis or spinal canal stenosis. Moderate hypertrophic degenerative changes of the posterior facets and ligamentum flavum are seen as well.Several lobulated cystic nonenhancing pelvic structures are visualized, possibly relating to ovarian cysts.
1. The previously identified low central lesion at the anterior L4 ventral epidural space is no longer visualized and may have related to a sequestered disc fragment which has now resorbed, with only minimal ill-defined residual low signal in this area without mass effect, possibly related to scarring.2. Additional degenerative changes of the lumbar spine with associated grade 1 anterolisthesis of L4 over L5 appear similar to prior examination.3. Several lobulated cystic nonenhancing pelvic structures are visualized, possibly relating to ovarian cysts.