Female, 61 years old, with low back pain, pain over L lateral thigh. Alignment is anatomic. Vertebral body morphology is within normal limits. Marrow signal characteristics are heterogeneous but benign. There is mild inferior endplate edema at T12The visualized spinal cord and conus are within normal limits. The cauda equina is unremarkable except as discussed below. T12-L1: Mild facet hypertrophy. Mild bulging disk. No significant spinal canal or foraminal stenosis. L1-2: Mild facet hypertrophy. Loss of disk T2 signal with mild bulging and a small superimposed right paracentral extrusion. Mild effacement of the right ventral thecal sac but no significant generalized spinal canal stenosis or neuroforaminal narrowing. L2-3: Mild facet hypertrophy and ligamentum flavum thickening with small facet effusions. Loss of disk height and T2 signal. Disk bulging. Moderate generalized spinal canal stenosis with some crowding of the cauda equina nerve roots. Moderate left and mild right foraminal narrowing. L3-4: Moderate facet hypertrophy and ligamentum flavum thickening with facet effusions. Bulging disk asymmetric to the right. No significant generalized spinal canal stenosis. Moderate right and mild left foraminal narrowing. L4-5: Marked facet hypertrophy and ligamentum flavum thickening with large facet effusions and perhaps some small extracanalicular synovial cysts. Mild generalized spinal canal narrowing without significant nerve root crowding. Mild bilateral foraminal narrowing. L5-S1: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disk with a central annular fissure and protrusion. No significant spinal canal or neuroforaminal stenosis.
1. Multilevel spondylosis, most severely affecting the L2-3 level where disk bulging and posterior element hypertrophy result in any moderate spinal canal stenosis.2. Significant facet arthropathy is seen at L3-4 and L4-5.