Low back pain Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of L2 on L3, L3 on L4, and L4 on L5 with some loss of lordosis similar to prior. Multilevel degenerative changes are seen with disc desiccation and height loss at L2-L3, L3-L4, L4-L5 which have mildly progressed since 2007. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: Mild disc bulge, ligamentum flavum thickening, and facet arthropathy resulting in mild spinal canal stenosis, which is progressed in the interval. No significant neural foraminal narrowing.L2-L3: Loss of disc height, disc bulge, disc bulge, moderate bilateral facet arthropathy, ligamentum flavum thickening and prominence of the dorsal epidural fat. There is moderate to severe spinal canal stenosis which has progressed in the interval. There is moderate left and mild to moderate right neural foraminal stenosis.L3-L4: Loss of disc height, disc bulge, moderate bilateral facet arthropathy, ligamentum flavum thickening and prominence of the dorsal epidural fat. There is moderate to severe spinal canal stenosis which has slightly progressed in the interval. There is moderate to severe left and mild right neural foraminal stenosis. There is a left foraminal and extraforaminal disc protrusion which contacts the exiting left L3 nerve root.L4-L5: Loss of disc height, disc bulge, advanced bilateral facet arthropathy, and ligamentum flavum thickening. There is moderate to severe spinal canal stenosis which has slightly progressed in the interval. There is severe right and moderate to severe left neural foraminal stenosis which may be impinging on the exiting L4 nerve roots, particularly on the right.L5-S1: No significant disc disease. Mild right neural foraminal narrowing. No spinal canal or left neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
1. Degenerative changes throughout the lumbar spine which have mildly progressed since 6/25/2007.2. There is moderate to severe spinal canal stenosis at L2-L3, L3-L4, L4-L5 which has progressed in the interval. 3. Neural foraminal stenosis at multiple levels as detailed above, severe at the right L4-L5 level where there may be impingement of the right L4 nerve root. 4.Facet arthropathy is also seen throughout the lumbar spine, worst at L4-L5, which may be also be contributing to patient's low back pain.