Worsening sciatica. Degenerative anterior subluxation of L4 relative to L5 remains minimal. The vertebral bodies are preserved in height. There is mild disc height loss at L5-S1 and moderate at the other levels, which is not significantly changed. The associated degenerative endplate/subjacent marrow changes have slightly increased on the right side at L5-S1 and L1-L2 levels. Spinal canal stenosis remains most most severe at L4-L5, which is very minimally increased since the previous examination. The conus medullaris tip remains at the upper L2 level. The nerve roots are redundant above the severe L4-L5 stenosis as before.Small rounded T2-hyperintense lesions in the right kidney are minimally larger. These may represent cysts though are not completely assessed. The gallbladder is distended. This has not significantly changed since the previous examination.T10-T11 and T11-T12: Limited assessment only in the sagittal plane, shows disc bulges and osteophytes causing mild-moderate spinal canal stenosis. There is suggestion of increased, now moderate-to-severe right foraminal stenoses. T12-L1: Mild disc bulge and facet arthropathy but no significant spinal canal or neural foraminal stenosis.L1-L2: The disc bulge which is eccentric to the right is minimally increased, posteriorly displacing the traversing right L2 nerve root and moderately narrowing the right neural foramen. There is moderate right and mild left facet arthropathy and mild-to-moderate ligamenta flavum thickening. These findings result in mild-to-moderate narrowing the spinal canal and the moderate right worse than left neural foraminal stenosis.L2-L3: The disc bulge is eccentric to the left and is stable. There is mild facet arthropathy and ligamenta flavum thickening. There is mild spinal canal and unchanged mild bilateral neuroforaminal stenoses.L3-L4: Moderate right more than left facet arthropathy and ligamenta flavum thickening along with disc bulge are unchanged and results in mild-to-moderate spinal canal stenosis as well as mild-to-moderate right and mild left neural foraminal stenoses.L4-L5: There is severe left worse than right facet arthropathy and severe ligamentum flavum thickening along with disc uncovering and a bulge that is eccentric to the right. The disc shows slightly increased right foraminal/extraforaminal component resulting in slight increase of the severe spinal canal stenosis and the moderate right foraminal stenosis as well as increased abutment of the extraforaminal part of the right L4 nerve root. Moderate left foraminal stenosis unchanged. L5-S1: Moderate facet arthropathy and mild-to-moderate ligamenta flava thickening as well as disc bulge result in mild-to-moderate spinal canal stenosis and moderate right foraminal stenoses. The right far lateral component of the disc does abut the exiting right L5 nerve root which is increased since the previous examination.
1.The multifactorial severe spinal canal stenosis at L4-L5 has minimally increased as the right foraminal/extraforaminal component of the disc bulge has increased.2.There is increased abutment of the extraforaminal right L5 nerve root by the L5-S1 disc.3.The L1-L2 disc bulge has slightly increased on the right affecting the right traversing L2 and exiting L1 nerve root.