Female, 47 years old, with back pain and numbness in the right leg. Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits allowing for a mild concavity of the superior T11 endplate. No evidence of marrow edema or concerning marrow replacement is seen. The visualized distal spinal cord, conus and cauda equina are unremarkable except as discussed below.T10-11: Small left paracentral/foraminal disc extrusion which mildly narrows the left neural foramen. No significant interval changes.T11-12: Mild facet hypertrophy. Mild loss of disc height with slight disc bulging. No significant spinal canal or foraminal stenosis. No significant interval changes.T12-L1: Unremarkable.L1-2: Unremarkable. L2-3: Unremarkable. L3-4: Progressive moderate facet hypertrophy, particularly on the right with there is a large facet joint effusion and subchondral cystic degeneration. Ligamentum flavum thickening. Mild disc bulging. No significant generalized spinal canal stenosis. No significant neuroforaminal narrowing. L4-5: Progressive advanced facet hypertrophy with large facet joint effusions bilaterally. Significant ligamentum flavum thickening. A new cyst is evident arising from the right ligamentum flavum projecting into and effacing the right dorsal aspect of the spinal canal. A sliver-like area of cystic degeneration also seems to be new within the left ligamentum flavum. Mild disc bulging is seen. These findings contribute to produce a moderately severe generalized spinal canal stenosis, new from prior, with slight crowding of the nerve roots of the cauda equina. The neural foramina are not significantly narrowed. L5-S1: Facet hypertrophy. Mild bulging disc. No significant spinal canal stenosis. Minimal right foraminal narrowing, slightly progressed.
Progressive degenerative findings are seen, primarily affecting the posterior elements at L3-4 and L4-5. For example, there is significant facet degeneration at L3-4 with facet effusion on the right. At L4-5, there is marked bilateral facet degeneration with effusions, and a large new cyst arising from the right ligamentum flavum which projects into the spinal canal and contributes to a moderately severe canal stenosis.