Male, 88 years old, with back pain. A grade 1 anterolisthesis of L4 relative to L5 is seen. Spinal alignment is otherwise unremarkable. Vertebral body morphology is unremarkable allowing for the presence of small Schmorl's nodes at lower lumbar levels. Marrow signal characteristics are unremarkable.The visualized spinal cord and conus are within normal limits. Details of the cauda equina be discussed by level as follows.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. Bulging disc preferentially towards the neural foramina. No significant generalized spinal canal stenosis. Very mild right foraminal narrowing. L3-4: Severe facet hypertrophy and ligamentum flavum thickening. Mild bulging disc. Mild generalized spinal canal stenosis but without significant crowding of the cauda equina. Moderate bilateral foraminal narrowing. L4-5: Severe facet hypertrophy and ligamentum flavum thickening and a subcentimeter right posterior lateral synovial cyst. Disc bulging and disc uncovering. Moderate generalized spinal canal narrowing with crowding of the cauda equina. Severe left and moderate right foraminal narrowing. L5-S1: Severe facet hypertrophy and ligamentum flavum thickening. Bulging disc with a superimposed right paracentral extrusion. No significant spinal canal stenosis. Severe right and mild left foraminal narrowing.
1.Marked facet arthropathy at lower lumbar levels.2.Disc degeneration, posterior element hypertrophy and spondylolisthesis at L4-5 result in a moderate generalized spinal canal narrowing with some crowding of the cauda equina. Severe left and moderate right foraminal narrowing is evident at this level.3.Disc degeneration and posterior element hypertrophy at L5-S1 resulting in a severe right neuroforaminal narrowing at this level.