FINDINGS: The alignment of the lumbar spine is notable for 5 mm anterolisthesis of L5 on S1 and 5
mm retrolisthesis of L3 on L4. There is normal alignment of the remaining levels. Vertebral body
height is maintained. Marrow signal is notable for edema which appear to be related to endplate
disc degenerative changes at the inferior endplate of T12 and the superior endplate of L3.
At T12-L1, there is a broad disc bulge with a small focal central protrusion, but no significant
central canal or neural foraminal narrowing.
At T12-L2, there is minimal disc bulge without significant central canal or neural foraminal
narrowing. There is some loss of normal disc water content and associated endplate disc
degenerative changes, especially anteriorly at the T12 inferior endplate.
At L1-2, the disc appears normal with no central canal or neural foraminal narrowing.
At L2-3, the disc is also unremarkable with no central canal or neural foraminal narrowing.
At L3-L4, adjacent to the fused L4-4/S1 segment, there is 5 mm degenerative retrolisthesis of L3
on L4, combining with facet arthropathy, to produce moderate to severe bottle lateral or foraminal
narrowing, and mild central stenosis. There is endplate edema as well as some edema associated
with the left-sided L3-4 facet.
The L4-5 and L5-S1 segments show a solid bony fusion with no hardware present at this time. There
is no central canal or neural foraminal stenosis at these levels. There is a 5 mm anterolisthesis
of L5 on S1, but this is in a solidly fused position and is not associated with significant
narrowing or impingement.
IMPRESSION: Chronic L4-5 and L5-S1 fusion. L3-4 disc disease likely related to adjacent segment
physiology because of the fused lower lumbar region putting greater stress on this level. There is
facet arthropathy, endplate disc degenerative change, and 5 mm degenerative retrolisthesis of L3 on
L4. There is associated moderate to severe bilateral neural foraminal narrowing.