Low back pain For the purposes of numbering, the most inferior well-defined disc space is labelled L5-S1. Again seen is a severe compression fracture involving the L3 vertebral body with approximately 70% loss of height similar to prior. There is edema involving the L3 vertebral body, also similar to prior. Interval placement of cement/kyphoplasty at the L3 vertebral body is seen. No significant osseous retropulsion.Remainder of the vertebral body heights are normal. Alignment is grossly maintained in the lumbar spine. There are diminished posterior osseous elements from L3-L4 to the sacrum reflecting combination of prior laminectomies and dysplasia.The spinal cord remains low-lying with the distal neural tissue/conus extending to the L5 level. Septations/adhesions are again again noted in the thecal sac from the L5 to S1 levels similar to priorDegenerative changes are specified by the intervertebral level as follows and unchanged since 2/22/2016: T12-L1: No spinal canal or neural foraminal stenosis.L1-L2: There is bilateral facet hypertrophy and ligamentum flavum thickening. There is minimal disc bulge. There is unchanged mild central canal stenosis and bilateral mild to moderate neural foraminal stenosis.L2-L3: There is bilateral facet hypertrophy and ligamentum flavum thickening. There is diffuse disc bulge without significant change in moderate to severe spinal canal stenosis and moderate bilateral foraminal stenosis. L3-L4: There is bilateral facet hypertrophy and ligamentum flavum thickening. There is also mild disc bulge with unchanged mild spinal canal stenosis and mild bilateral foraminal stenosis, relatively worse on the right. L4-L5: There is bilateral facet hypertrophy. There is central disc protrusion. No significant spinal canal stenosis. There is unchanged mild bilateral foraminal narrowing, relatively worse on the left.L5-S1: There is bilateral facet hypertrophy without neuroforaminal narrowing or spinal stenosis.
1. Compared to 2/22/2016, there is no significant change in moderate to severe spinal canal stenosis at the L2-L3 level.2. No significant change in compression fracture with approximately 70% height loss of the L3 vertebral body with interval changes of vertebroplasty.3. Unchanged appearance of the low-lying conus which extends to the L5 level. Again seen is evidence of prior cord detetherings. 4. Degenerative changes at additional levels as detailed above.