Female, 85 years old, with low back pain. Thoracic:Spinal alignment is anatomic. Vertebral body heights are preserved. Scattered areas of marrow signal change, largely T1 isointense and T2 hyperintense, within the T9 and T10 vertebral bodies, and the T8 left lamina, were present on the prior examination and likely reflect benign hemangiomas. No worrisome marrow replacement is seen.The spinal cord demonstrates normal signal intensity throughout. No epidural lesions are suspected. Multilevel disc degeneration is seen, appearing similar to the prior examination. At T10-11, disc bulging with facet arthropathy and ligamentum flavum thickening produce a mild spinal canal stenosis and mild foraminal narrowing. At T11-12, disc bulging along with facet arthropathy, left greater than right, and ligamentum flavum thickening produce a moderate spinal canal stenosis with slight cord deformation and severe left foraminal narrowing.A hiatal hernia is noted incidentally. The thyroid contains multiple nonspecific nodules.Lumbar:An S-shaped scoliotic curvature of the lumbar spine is seen. Grade 1 anterolisthesis of L4 relative to L5, and L5 relative to S1 is seen. Evidence of posterior instrumented fusion from L4 to L5 is demonstrated. Alignment is grossly unchanged. A laminectomy defect is also redemonstrated at L4-5. Marrow signal characteristics are extremely heterogeneous. This likely reflects degenerative endplate signal alteration. Apart from some lateral wedging related to scoliosis, the vertebral body heights are preserved.The distal spinal cord and conus are within normal limits. No significant impingement of the cauda equina is seen. No epidural abnormalities are detected.General progression of degenerative findings is seen with further loss of disc height and endplate irregularity at most levels. Additional level specific findings are as follows:L1-2: Progressive facet arthropathy, particularly on the right. Slightly progressive disc bulging without significant spinal canal stenosis. Severe progressive right foraminal narrowing. L2-3: Facet arthropathy and ligamentum flavum thickening slightly progressed. Progressive disc bulging with greater effacement of the left lateral recess and a mild generalized canal stenosis. Moderate bilateral foraminal narrowing, progressed. L3-4: Postoperative changes. Facet arthropathy grossly similar to prior. Bulging disc and mild spinal canal narrowing, similar to prior. Severe left and mild right foraminal narrowing, unchanged. L4-5: Postoperative changes. Facet arthropathy grossly similar to prior. No significant spinal canal or foraminal stenosis. L5-S1: Facet arthropathy and ligamentum flavum thickening grossly similar to prior. Disc bulging, unchanged. No significant spinal canal stenosis. Mild bilateral foraminal narrowing, unchanged.
1.Severe disc and posterior element degeneration is again seen in the lumbar spine with progression at most levels. No high-grade spinal canal stenosis is seen. However, scattered severe foraminal narrowing is noted as above. Postoperative findings are redemonstrated compatible with posterior instrumented fusion and laminectomy at L4-5.2.Moderate degenerative findings are seen in the thoracic spine without significant interval change. There is narrowing of the spinal canal at T10-11 and T11-12. No acute lesions are seen.