Female, 67 years old, with low back pain and hyperreflexia in the upper extremities but present sensory and motor exam. Cervical:Alignment is anatomic. Vertebral body height and morphology are within normal limits. No evidence of marrow replacement or edema is seen.The spinal cord demonstrates normal signal intensity and morphology throughout. No epidural abnormalities are suspected.At C5-6 there is minimal posterior disc-osteophyte complex formation and left facet hypertrophy resulting in a mild left foraminal stenosis. Minimal posterior disc-osteophyte complex formation is seen at C6-7 as well without significant spinal canal or foraminal stenosis. Perineural root sleeve cysts are evident within the C7-T1 neural foramen, but this is a common incidental finding.Lumbar:Grade 1 anterolisthesis of L3 relative to L4 is noted. Elsewhere, sagittal alignment is unremarkable. Vertebral body heights are within normal limits. Extensive degenerative endplate signal abnormality is seen at L3-4 and L4-5 but no worrisome marrow replacement is seen.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable except as discussed below. No epidural abnormalities are seen.L1-2: Facet arthropathy. Minimal disc bulging. No significant spinal canal or foraminal stenosis. L2-3: Facet arthropathy. No significant spinal canal or foraminal stenosis. L3-4: Marked facet arthropathy and ligamentum flavum thickening. Disc bulging and disc uncovering asymmetric to the left. Moderate generalized spinal canal narrowing with some crowding of the nerve roots of the cauda equina. Both lateral recesses are narrowed. The left neural foramen is significantly narrowed with possible nerve root impingement. The right neural foramen remains patent. L4-5: Marked facet arthropathy and ligamentum flavum thickening. Bulging disc asymmetric to the right with a right paracentral protrusion. Moderate generalized narrowing of the spinal canal with right greater than left lateral recess effacement. The right neural foramen is moderately to severely narrowed while the left neural foramen is patent. L5-S1: Facet arthropathy. Minimal bulging disc. No significant spinal canal stenosis. Mild right foraminal narrowing.
1.No significant abnormalities are detected in the cervical spine to account for the patient's symptoms.2.Spinal canal narrowing with nerve root crowding is seen at L3-4 and L4-5. In addition, the left L3-4 and right L4-5 neural foramina demonstrate significant narrowing.