Male, 79 years old, with low back pain. A grade 1 anterolisthesis of L4 relative to L5 is seen, likely secondary to pronounced facet hypertrophy at L4-5. Spinal alignment is otherwise unremarkable. Vertebral body morphology is within normal limits. No concerning marrow signal abnormality is detected.The visualized spinal cord conus are unremarkable.The disks show diffuse loss of T2 signal. Loss of disk height is evident at L5-S1. Additional level specific findings are as follows:L1-2: Unremarkable. L2-3: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. L3-4: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. L4-5: Marked facet hypertrophy with effusion on the right. There may also be a synovial cyst projecting posteriorly from the facet joint on the right. The ligamentum flavum is thickening. Mild disk bulging/disk uncovering. Mild generalized spinal canal stenosis. Moderate right and mild left foraminal narrowing. L5-S1: Moderate facet hypertrophy. Mild bulging disk. No significant generalized spinal canal stenosis. Mild bilateral neuroforaminal narrowing. Bilateral renal cystic lesions are seen incidentally.
Marked facet degeneration is seen at L4-5. This likely contributes to a grade 1 anterolisthesis of L4 relative to L5. Disk uncovering and posterior element hypertrophy at this level cause a mild spinal canal stenosis with a moderate narrowing of the right neural foramen.