Female, 68 years old, with pain in the L5 distribution. Spinal alignment is anatomic. Vertebral body morphology is within normal limits. No concerning marrow replacement is seen. Mild osseous and extraosseous edema is present along the L4-5 facet complexes.The visualized spinal cord, conus and cauda equina demonstrate normal signal characteristics and morphology.L1-2: Unremarkable. L2-3: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. L3-4: Moderate facet hypertrophy and ligamentum flavum thickening. Mild predominantly laterally bulging disk. Mild narrowing of the spinal canal. No significant foraminal narrowing. L4-5: Moderate facet hypertrophy and ligamentum flavum thickening with small facet effusions. Moderately bulging disk with perhaps a superimposed right paracentral protrusion. Severe spinal canal stenosis with crowding of the cauda equina and near complete exclusion of CSF. Minimal bilateral foraminal narrowing. L5-S1: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disk with a small superimposed central protrusion. No significant spinal canal stenosis. No significant foraminal narrowing.
1. Severe spinal canal stenosis at L4-5 arising from disk degeneration and posterior element hypertrophy.2. Edematous facet arthropathy at L4-5 bilaterally.