Male, 72 years old, with mid back pain around L2 and sciatica radiating to the left buttock. History of stem cell transplant for AML three months ago. Alignment is anatomic. Vertebral body heights are preserved. Marrow signal characteristics are diffusely hypointense on T1 and T2-weighted images, though there is no evidence of concerning edema or STIR signal abnormality.The visualized distal spinal cord and conus are within normal limits. The cauda equina is also unremarkable except as discussed below. No epidural abnormalities are suspected.Disc degeneration is seen at all levels with reduced disc height and endplate irregularity. At L4-5 and L5-S1, there is near-complete loss of disc height is seen. Additional level specific findings are as follows:T12-L1: Mild facet arthropathy. No significant spinal canal or foraminal stenosis. L1-2: Mild facet arthropathy. Minimal disc bulging. No significant spinal canal or foraminal stenosis.L2-3: Facet arthropathy and ligamentum flavum thickening. Disc bulging. Moderate generalized spinal canal stenosis with crowding of the cauda equina and near complete effacement of CSF. Mild bilateral foraminal narrowing. L3-4: Facet arthropathy and ligamentum flavum thickening. Disc bulging. Moderate generalized spinal canal stenosis with crowding of the cauda equina and near complete effacement of CSF. Mild bilateral foraminal narrowing. L4-5: Marked facet arthropathy. Ligamentum flavum thickening. Bulging disc. Moderate to severe spinal canal stenosis with crowding of the cauda equina and effacement of CSF. Moderate right and mild left foraminal narrowing. L5-S1: Marked facet arthropathy. Bulging disc. No significant spinal canal stenosis. Mild to moderate bilateral foraminal narrowing.
1.Diffuse hypointense signal in the bone marrow is seen without concerning edema or STIR signal abnormality. This likely represents marrow reconversion as a reaction to chronic anemia, transplantation or treatment.2.Multilevel disc and posterior element degeneration is seen with significant associated spinal canal stenoses at L2-3, L3-4 and L4-5. In addition there is significant foraminal narrowing on the right at L4-5.