Male, 64 years old, with left-sided sciatica. Spinal alignment is grossly anatomic. Marrow signal intensity is heterogeneous but without suspicious marrow replacement. Mild edema of the L1-2 disc and endplates is seen, likely degenerative in nature. Elsewhere, no significant marrow edema is detected.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No epidural abnormality is suspected.With the exception of the L2-3 intervertebral discs, all of the lumbar discs demonstrate loss of height. T1 and T2 hyperintense signal within the L3-4 and L4-5 disc spaces is likely related to disc degeneration or disc mineralization. Additional level specific findings are as follows:L1-2: Moderate facet arthropathy and ligamentum flavum thickening. Mild disc bulging. Mild generalized spinal canal narrowing without obvious nerve root impingement. The neural foramina are mildly narrowed. L2-3: Moderate facet arthropathy and ligamentum flavum thickening. Minimal disc bulging. No significant spinal canal or foraminal stenosis. L3-4: Moderate facet hypertrophy. No significant spinal canal or foraminal stenosis. L4-5: Advanced facet arthropathy which is particularly bulky on the left causing effacement of the left lateral recess and a moderately severe left foraminal narrowing. The right neural foramen is mildly narrowed. The spinal canal itself is mildly narrowed. L5-S1: Advanced facet arthropathy. Minimal disc bulging with a central annular fissure. The neural foramina are mildly narrowed. No significant spinal canal narrowing is seen.
1.Multilevel disc degeneration but without evidence of any high-grade spinal canal stenosis.2.Facet arthropathy which becomes progressively worse at lower lumbar levels. At L4-5 on the left, this results in a significant narrowing of the neural foramen.