Chronic low back pain, symptoms of spinal stenosis, new onset bowel/bladder control problems since 2 months Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild exaggeration of lumbar lordosis, levoscoliosis of the mid to lower lumbar spine, and grade 1 anterolisthesis of L4 and L5. These findings were present on prior study and can be further assessed with upright radiographs. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are again seen with multilevel disc bulges and disc height loss which is severe at the L3-4 level, similar to prior. Additional details as below:L1-L2: Mild disc bulge with small right central protrusion as before. Minimal right neural foraminal narrowing. No spinal canal or left neural foraminal stenosis.L2-L3: Disc bulge eccentric to the right with effacement of the right lateral recess as before. Mild to moderate right neural foraminal stenosis. Left neural foramen is patent.L3-L4: There is moderate to severe spinal canal stenosis at this level related to combination of disc bulge which is eccentric to the right, moderate degree of bilateral facet arthropathy, and prominence of the dorsal epidural fat. Degree of stenosis is minimally worse in the interval. There is effacement of the bilateral lateral recesses. There is moderate right-sided neural foraminal stenosis. Left neural foramen is patent.L4-L5: There is severe spinal canal stenosis at this level related to combination of disc bulge, grade 1 anterolisthesis, advanced bilateral facet arthropathy, and ligamentum flavum thickening. There is effacement of the lateral recesses. There is moderate to severe left neural foraminal stenosis and mild right neural foraminal narrowing similar to prior. L5-S1: Mild disc bulge and bilateral facet arthropathy, severe on the left. There is no significant spinal canal or neural foraminal stenosis. Paraspinous soft tissues are within normal limits.
1. Multilevel degenerative changes in the lumbar spine with severe L4-L5 and moderate to severe L3-L4 spinal canal stenoses which is stable to minimally worse since 11/28/2014. Additional details including neural foraminal stenoses as above, relatively worse at the left L4-L5 and right L3-L4 levels.2. Degenerative grade 1 anterolisthesis at L4-L5 as well as levoscoliosis of the lumbar spine can be further assessed with upright radiographs as clinically indicated.