 Redemonstrated is mild levorotoscoliosis with its apex centered at approximately L3. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. Other than a right simple renal cyst, the visualized intra-abdominal and paraspinal contents are unremarkable.Disc desiccation is present throughout from L2 through S1. Disc height loss is noted at is: significant at L2/3, mild at 3/4, moderate at L/5, and mild at L5/S1. Mild edematous discogenic reactive endplate changes (Modic type I) are evident at L2/3 and L4/5.Redemonstrated is posterior scalloping of the T11 and T12 vertebral bodies with CSF signal intensity extending into the left neural foramen at the T11-T12 foramen and extending along the leftward epidural space. These findings are unchanged in appearance and are thus felt to represent benign change, given the 7 year stability.At the L1-L2 level, bilateral neural foramen are patent without evidence of central canal stenosis, unchanged. At the L2-L3 level there is new asymmetric bulge to the right, slight ligamentum flavum thickening, and mild bilateral facet hypertrophy with mild right neural foraminal stenosis.At the L3-L4 level there is new mild disc bulge, however the bilateral neural foramen and central canal remain patent without evidence of stenosis. At the L4-L5 level there are new changes as follows: Large right foraminal/lateral disc extrusion with associated free fragment posterolaterally effacing the adjacent nerve roots, central disc protrusion, mild disc bulge, ligamentum flavum thickening, and mild to moderate bilateral facet hypertrophy. There is mild central, mild bilateral lateral recess, and severe right lateral neural foraminal stenosis.At the L5-S1 level, bilateral neural foramen are patent without evidence of central canal stenosis. Facet osteoarthritis seen in the left greater than right at this level. In the left lateral aspect of the disc there is high signal compatible with an annular tear. These findings are unchanged.
1.At the L2-L3 level there is new asymmetric bulge to the right with mild right neural foraminal stenosis.2.At the L4-L5 level there are new changes as follows: Large right foraminal/lateral disc extrusion with associated free fragment posterolaterally effacing the adjacent nerve roots, central disc protrusion, mild disc bulge, ligamentum flavum thickening, and mild to moderate bilateral facet hypertrophy. There is mild central, mild bilateral lateral recess, and severe right lateral neural foraminal stenosis.