Back pain For the purposes of numbering, there are 5 nonrib-bearing lumbar vertebral bodies with mild sacralization involving the right aspect of the L5 vertebra. Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of L4 on L5 and L5 on S1 with advanced facet arthropathy evident bilaterally at these levels. CT may be helpful to assess for pars defect. Bone marrow signal is benign including T1 hyperintense lesion involving the left posterior aspect of the T12 vertebral body compatible with a hemangioma. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L3-L4: Minimal disc bulge and mild facet arthropathy. No significant spinal canal or neural foraminal stenosis. L4-L5: There is grade 1 anterolisthesis with disc uncovering, minimal bulge, and mild disc height loss. There is also advanced bilateral facet arthropathy. There is mild to moderate left neural foraminal narrowing. No significant spinal canal or right neural foraminal narrowing at this level. There is however mild spinal canal stenosis just inferior to the L4-L5 disc level involving the lateral aspects of the thecal sac.L5-S1: There is grade 1 anterolisthesis with disc uncovering, dorsal annular fissure, moderate disc height loss, and there is no significant spinal canal stenosis at any level. Advanced bilateral facet arthropathy. There is no significant central canal stenosis. There is partial effacement of the lateral recesses. There is mild to moderate right and no significant left neural foraminal narrowing. Paraspinous soft tissues are unremarkable. Small perineural cysts in the sacrum are incidentally noted.
Degenerative changes at the L4-L5 and L5-S1 levels including advanced bilateral facet arthropathy and grade 1 anterolisthesis at these levels. There is mild narrowing of the spinal canal just inferior to the L4-L5 disc level related to the facet arthropathy. There is also mild to moderate neural foraminal narrowing at the left L4-L5 and right L5-S1 levels. No higher grade spinal canal or neural foraminal stenosis is appreciated.