Female, 74 years old, with worsening back pain. Assess for spinal stenosis. Spinal alignment is anatomic. Vertebral body morphology is within normal limits. Marrow signal characteristics are mildly heterogeneous, but there is no evidence of concerning marrow replacement or marrow edema. The visualized spinal cord, conus and cauda equina are unremarkable.L1-2: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L2-3: Moderate facet hypertrophy and ligamentum flavum thickening. Mild bulging disc with a small superimposed right paracentral superior extrusion, and a right foraminal protrusion. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L3-4: Moderate facet hypertrophy and ligamentum flavum thickening. Bulging disc with a right foraminal and far lateral predominance. No significant spinal canal stenosis. Moderate right foraminal narrowing. L4-5: Severe facet hypertrophy and ligamentum flavum thickening. Minimal bulging disc. No significant spinal canal stenosis. Mild left foraminal narrowing. L5-S1: Severe right and moderate left facet hypertrophy. No significant spinal canal stenosis. Mild bilateral foraminal narrowing.
Relatively mild multilevel degenerative disc disease with no areas of high-grade spinal canal or neuroforaminal stenosis.Facet arthropathy does become progressively worse at lower levels, with severe degeneration affecting L4-5 bilaterally and L5-S1 on the right.