Male, 58 years old, with pressure ulcer. Spinal alignment is anatomic. Mild degenerative vertebral body height loss is seen at L5. No concerning marrow replacement or edema is seen.The visualized spinal cord, conus and cauda equina are unremarkable except as discussed below.Enhancement within the L4-5 and L5-S1 disc spaces is probably degenerative given the absence of enhancement or edema in the adjacent endplates. No evidence of pathologic enhancement is seen within the spinal canal itself. At most, there may be some vascular congestive enhancement due to spinal stenosis at L4-5 and L5-S1.The subcutaneous and paraspinal soft tissues of the lower lumbar and sacral regions show evidence of edema and some mild enhancement. A 4 cm wide region of hypoenhancement is evident within the soft tissues just dorsal to the sacrum. This is evident on only the last several slices of the exam.L1-2: Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L2-3: Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L3-4: Marked facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L4-5: Marked facet hypertrophy and ligamentum flavum thickening. Bulging disc with a superimposed central protrusion. Moderate spinal canal stenosis with slight crowding of the cauda equina. Moderate bilateral foraminal narrowing. L5-S1: Marked facet hypertrophy and ligamentum flavum thickening. Bulging disc with a large right anteriorly directed disc osteophyte complex. At least moderate spinal canal stenosis with crowding of the cauda equina nerve roots. Severe bilateral foraminal narrowing.
1.The subcutaneous and paraspinal soft tissues of the lower lumbar and sacral regions show evidence of inflammation. In addition, a region of hypoenhancement within the soft tissues just dorsal to the sacrum is incompletely imaged on this study. Findings could represent the reported pressure ulceration.2.Disc degeneration most severely affecting the L4-5 and L5-S1 levels where significant spinal canal stenoses are seen. In addition, severe bilateral foraminal narrowing is present at L5-S1.