Radicular low back pain. History of spinal stenosis. Left lower extremity pain and weakness. The study is limited mildly by patient motion and body habitus. Five lumbar type vertebral bodies are present, which are appropriate in overall alignment and height, accounting for straightening. There is diffusely hypointense vertebral bone marrow signal that is probably reflective of red marrow reconversion. The lower spinal cord and conus medullaris are unremarkable. At L4-5, there is a disk bulge without significant central canal stenosis. There is moderate to severe left and moderate right neural foraminal narrowing, unchanged. At L5-S1, an eccentrically right-sided disc extrusion results in compression of the right subarticular recess and to a lesser extent the left lateral recess, as well as severe right and moderate left neural foraminal narrowing. There is bilateral facet productive changes and mild bilateral ligamentum flavum hypertrophy and buckling, which also contribute to spinal canal narrowing at this level.
An L5-S1 disc extrusion with compression of the right subarticular recess results in severe narrowing of the right neural foramen, although this has not significantly changed since September 2013.