Female, 58 years old, with low back pain and left-sided radiculopathy. Spinal alignment is anatomic. Mild anterior wedging of the L3 vertebral body is unchanged. The remaining vertebral bodies demonstrate normal height and morphology. No areas of concerning marrow replacement or marrow edema are detected.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable except as discussed below. No epidural abnormalities are suspected. The lumbar spinal canal is congenitally slender to which prominence of the dorsal epidural fat contributes.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Mild facet arthropathy. Ligamentum flavum thickening. Minimal bulging disc. Mild spinal canal narrowing. Mild right foraminal narrowing. No interval changes. L3-4: Facet arthropathy. Ligamentum flavum thickening. Bulging disc. Moderate spinal canal narrowing with crowding of the cauda equina and near complete exclusion of CSF. Findings have progressed. Moderate bilateral foraminal narrowing is unchanged. L4-5: Facet arthropathy. Ligamentum flavum thickening. Bulging disc. Moderate spinal canal stenosis with crowding of the cauda equina and near complete exclusion of CSF. Findings have progressed. Moderate to severe bilateral foraminal narrowing, also slightly progressed. L5-S1: Facet arthropathy. Ligamentum flavum thickening. Bulging disc and osteophytic ridging. No significant spinal canal stenosis. Severe left foraminal narrowing with nerve root impingement. Severe right neuroforaminal narrowing with possible nerve root impingement. Findings are unchanged.
1.Mild worsening of degenerative disease is seen at L3-4 and L4-5 where spinal canal stenosis has progressed and there is crowding of the cauda equina.2.Severe bilateral neuroforaminal narrowing is redemonstrated at L5-S1, but particularly on the left where there is nerve root impingement. These abnormalities, however, have not significantly changed from prior.