Female, 70 years old, with low back pain. A grade 1 anterolisthesis of L3 relative to L4, and L4 relative to L5 is seen. Vertebral body heights are preserved. Marrow signal characteristics are within normal limits.The visualized distal spinal cord and conus are within normal limits. The cauda equina is unremarkable except as discussed below. No epidural abnormalities are suspected.L1-2: Facet arthropathy and ligamentum flavum thickening. Minimal disc bulging. Mild spinal canal narrowing. Mild bilateral foraminal narrowing. L2-3: Facet arthropathy and ligamentum flavum thickening. Minimal disc bulging. Mild spinal canal narrowing. Mild bilateral foraminal narrowing. L3-4: Advanced facet arthropathy and ligamentum flavum thickening. Disc bulging and disc uncovering. Severe spinal canal stenosis with crowding of the cauda equina. Mild bilateral foraminal narrowing. L4-5: Advanced facet arthropathy and ligamentum flavum thickening. Disc bulging and disc uncovering. Severe spinal canal stenosis with crowding of the cauda equina. Moderate left and mild right foraminal narrowing. L5-S1: Advanced facet arthropathy. Minimal disc bulging. No spinal canal or foraminal stenosis.
Multilevel disc and posterior element degeneration is seen. At L3-4 and L4-5, these findings result in severe spinal canal stenosis with crowding of the cauda equina.