Female, 52 years old, with neck pain and low back pain. Cervical:The cervical lordosis is mildly straightened which is likely positional. Sagittal alignment is otherwise unremarkable. Vertebral body morphology and signal characteristics are normal. No evidence of marrow replacement or marrow edema is seen.The visualized spinal cord shows normal signal intensity and morphology.Minimal disc osteophyte disease is seen at C3-4, C4-5 and C5-6 with very slight effacement of the ventral thecal sac. No significant spinal canal stenosis is detected.At C5-6, the left facet is hypertrophic which causes moderate left neuroforaminal narrowing. The remaining neural foramina are patent.Lumbar:Evidence of posterior approach surgery is seen at L3-4. Partial spinous process resection is seen and perhaps a partial laminectomy as well.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits allowing for a mild transitional morphology of the L5 vertebral body. No concerning marrow replacement or marrow edema is observed.Visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable.L1-2: Unremarkable. L2-3: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L3-4: Facet hypertrophy. The ligamentum flavum appears to have been surgically thinned. Bulging disc with a left foraminal annular fissure. Mild generalized spinal canal narrowing. Moderate bilateral foraminal narrowing. L4-5: Moderate facet hypertrophy and ligamentum flavum thickening. Bulging disc with a shallow central protrusion. Mild to moderate generalized spinal canal narrowing. Mild to moderate bilateral foraminal narrowing. L5-S1: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis.
1.Mild degenerative findings in the cervical spine with no evidence of significant spinal canal stenosis or cord impingement. Left facet hypertrophy at C5-6 does result in left-sided neuroforaminal narrowing at this level.2.Evidence of prior posterior approach surgery at L3-4. Posterior element hypertrophy and disc bulging at this level cause a mild spinal canal stenosis and moderate bilateral foraminal narrowing.3.Fairly significant posterior element hypertrophy is seen at L4-5 which, in combination with a bulging disc and central shallow disc protrusion, cause a mild to moderate canal stenosis. The neural foramina are also mildly to moderately narrowed at this level.