 For the purposes of numbering, the most inferior well-defined disc space is labeled L5-S1. There is minimal grade 1 retrolisthesis of L5 on S1, and minimal grade 1 anterolisthesis of L4 on L5, as before. The remainder of the spine shows normal alignment. There is loss of T2 signal in all visualized disks with moderate loss of disk height at L4-5 and L5-S1 with vacuum phenomena. There is diffusely heterogeneous marrow signal which is nonspecific. There are type II endplate degenerative changes at L4-5 and L5-S1. There is minimal edema in the right-sided L4 and L5 articulating facets and pedicles which is nonspecific, likely reflecting degenerative process with similar to prior. The conus terminates at L1-2 and shows normal caliber and signal.Individual levels as below:T12-L1: No significant disc disease. No spinal canal or neural foraminal stenosis.L1-2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-4: Minimal disk bulge and bilateral facet arthropathy contributing to mild to moderate left and mild right neural foraminal stenosis. No spinal canal stenosis.L4-5: Diffuse disk bulge, bilateral facet arthropathy and ligamentum flavum thickening causing moderate right and mild left neural foraminal stenosis and no significant central spinal stenosis. Disk material encroaches upon the right greater than left subarticular zones without significant central canal stenosis.L5-S1: Diffuse disk bulge asymmetric to the left with a left foraminal protrusion causing up to moderate left and mild right neural foraminal narrowing. There is also an osteophyte component more laterally abutting the left L5 nerve root. There is bilateral facet arthropathy. No significant spinal canal stenosis.
1. Multilevel degenerative changes in the lumbar spine not significantly changed since 2/28/2015. There is no significant central spinal canal stenosis at any level. There is up to moderate left L5-S1 neural foraminal stenosis where there may be impingement of the left L5 nerve root, similar to prior.2. Facet arthropathy at L3-4, L4-L5, and L5-S1, which may be contributing to patient's low back pain. There is bone marrow edema involving the posterior elements at the right L4-L5 and L5-S1 levels similar to prior.