Low back pain, left lower extremity neuropathic pain Five lumbar type vertebral bodies are present. Bilateral 12th ribs are hypoplastic. There is lumbar levoscoliosis with apex at the L2-L3 level. There is severe compression deformity involving the L4 vertebral body with approximately 70 to 80% loss of height. No edema seen within the vertebral body. There is also mild wedging involving the left superior endplate of the L3 vertebral body, which also remains unchanged since 2007.Round enhancing lesion is seen within the L4 vertebral body corresponding to focus with sclerotic rim on prior CT from 12/2013 and while nonspecific is favored to be benign. There is a larger focus of T1 hyperintensity involving the L3 vertebral body likely representing a hemangioma.Multilevel degenerative changes are seen, as described below:L1-L2: Diminished disk height with vacuum disk phenomena. There is mild bulge without significant spinal canal or left neural foramina stenosis. There is mild right neural foraminal narrowing.L2-L3: There is loss of disk height with vacuum disk phenomenon. There is mild disk bulge and mild to moderate right neural foraminal narrowing. No significant spinal canal or left neural foraminal narrowing.L3-L4: There is disk bulge and mild osseous retropulsion related to the chronic compression fracture. There is also ligamentum flavum thickening. There is resulting moderate spinal canal stenosis including the left lateral recess and the central canal. There is severe right neural foraminal narrowing. There is also moderate left neural foraminal narrowing.L4-L5: There is loss of disk height and vacuum disk phenomena. There is mild disk bulge. No significant central spinal canal narrowing. There is moderate left neural foraminal stenosis and mild right neural foramina stenosis.L5-S1: There is loss of disk height and vacuum disk phenomena. There is bilateral facet arthropathy. There is moderate to severe left and mild right neural foramina stenosis. No significant spinal canal stenosis.Again seen is chronic dissection involving the abdominal aorta, better assessed on prior CT angiogram. Visualized conus imaged on the axial images from from the lower T12 level is unremarkable. There is questionable T2 signal at the T11 level dorsally on the sagittal sequence, which may be artifactual or related to reported cord infarct.
1. Advanced degenerative changes in the lumbar spine with levoscoliosis with apex at the L2-L3 level similar to priors.2. Severe chronic compression fracture involving the L4 vertebral body and mild depression of the superior endplate involving the L3 vertebral body, which remain unchanged. No vertebral body edema.3. Moderate spinal canal stenosis at L3-L4 which is not significantly changed since 2007. Otherwise no significant spinal canal stenosis in the lumbar spine.4. Moderate to severe neural foraminal stenosis at multiple levels as detailed above including right greater than left at L3-L4, and on the left at L4-L5 and L5-S1 levels. 5. Visualized conus imaged on the axial images below the lower T12 level is unremarkable. There is questionable T2 signal abnormality at the T11 level dorsally which is not imaged on the axial lumbar sequence. Prior lower thoracic cord infarct was seen on prior MRI from 2004. If clinically warranted thoracic MRI can be obtained. 