 There is rightward convexity of the mid lumbar spine with apex of the curvature at L2. Vertebral body heights are unchanged. There is stable grade 1 retrolisthesis of L2 over L3 and L4 over L5. There has been mild progression of multilevel disc narrowing, moderate to severe in degree. There is multilevel disc desiccation. Severe multilevel degenerative changes of the lumbar spine is again demonstrated, with endplate irregularity and endplate marrow signal changes. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the L1-L2 level.Multilevel degenerative changes are seen, as described below:At T9-T10: On sagittal images, minimal disc bulge is seen. There is mild stenosis of the central canal. There is ligamentum flavum thickening.At T10-T11: On sagittal images, there is no definite abnormality.At T11-T12: On sagittal images, there is mild disc bulge. There is significant ligamentum flavum thickening. There is mild stenosis of the spinal canal.At T12-L1: There is a mild ventrolateral disc protrusion. There is ligamentum flavum-thickening. No foraminal narrowing or spinal canal stenosis.At L1-L2: This is a left far lateral disc osteophyte complex. There is mild left foraminal stenosis. There is moderate spinal canal stenosis. There is ligamentum flavum thickening and facet joint hypertrophy. No change from previous.At L2-L3: There is uncovering of the disc. There is narrowing of the lateral recesses and moderate left foraminal stenosis at this level. There is mild right foraminal stenosis. There is mild spinal canal stenosis. There is facet joint arthropathy.At L3-L4: There is posterior osteophyte disc complex causing moderate bilateral foraminal stenosis. There is moderate spinal canal stenosis. There is ligamentum flavum thickening and facet arthropathy. At L4-L5: There is uncovering of the disc with superimposed disc bulge with superimposed right foraminal/far lateral protrusion. There is moderate to severe right foraminal stenosis and moderate left foraminal stenosis. There is moderate spinal canal stenosis. There is ligamentum flavum thickening. There is facet arthropathy which has progressed in the interim trace facet joint effusions. At L5-S1: There is disc bulge causing moderate foraminal narrowing on the right and mild foraminal narrowing on the left. There is ligamentum flavum thickening and facet arthropathy. There is moderate spinal canal stenosis improved from previous.Tiny T2 hyperintense focus is seen in the posterior cortex of the left kidney, likely a small cyst. The left adrenal gland is minimally prominent and unchanged from previous. There is layering T2 hypointense debris in the dependent portion of the gallbladder. Paraspinous soft tissues are within normal limits.
1. Very minimal progression of multilevel severe degenerative changes of the lumbar spine, with findings most prominent at L4-L5 with moderate-severe right foraminal stenosis and moderate left foraminal stenosis. There has been interval progression in the facet arthropathy at this level.2. Moderate spinal canal stenosis at various levels, slightly improved at L5-S1.3. Minimal layering debris within the gallbladder which may represent stones or sludge. Further evaluation with ultrasound may be considered if clinically indicated.