Female, 73 years old, with worsening back pain. Trace anterolisthesis of L3 relative to L4 and L4 relative to L5 is again seen without significant change. Alignment is otherwise unremarkable.A subcentimeter focus of nonspecific marrow replacement within the L1 vertebral body shows no significant interval change. Marrow signal characteristics remain diffusely heterogeneous.Concavity of the L2 inferior endplate is similar to the prior examination. No adjacent marrow edema is seen.Mild edema is evident within the L3 vertebral body without significant endplate concavity or loss of vertebral body height.Since the prior examination, the L4 and L5 vertebral bodies demonstrate a mild generalized loss of vertebral body height. The L5 vertebral body demonstrates mild associated edema as well.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Facet arthropathy and ligamentum flavum thickening. Mild disc bulging. Mild generalized spinal canal narrowing with slight crowding of the cauda equina. Moderate bilateral foraminal narrowing. No interval changes. L3-4: Facet arthropathy. Ligamentum flavum thickening. Bulging disc. Moderate generalized spinal canal narrowing which appears to be slightly progressed from the prior examination. Mild bilateral foraminal narrowing, unchanged. L4-5: Facet arthropathy. Ligamentum flavum thickening. Disc bulging. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. No interval changes. L5-S1: No significant spinal canal stenosis or neuroforaminal narrowing.
1.Since the prior examination, mild compression deformities have developed at L4 and L5. Also noted is new edema within the L3 vertebral body which could indicate an impending compression deformity.2.Chronic concavity of the L2 inferior endplate is seen without evidence of marrow edema.3.A subcentimeter focus of marrow replacement within the L1 vertebral body is unchanged and nonspecific. Likewise, diffuse marrow heterogeneity is again seen which, on its own, is nonspecific. However, given the development of multiple compression deformities over the prior examinations, the possibility of more widespread osseous myelomatous involvement should be considered.4.Degenerative disc disease is seen, most severely affecting the L2-3 and L3-4 levels where there is spinal canal narrowing and some degree of nerve root crowding.