Female, 71 years old, with right foot pain. Assess for stenosis. Spinal alignment is within normal limits with the exception of a very mild curvature in the coronal plane. Vertebral body heights are maintained allowing for degenerative endplate irregularity. Mild degenerative endplate edema is seen at L1-2 and L5-S1. Predominantly fatty degenerative endplate signal change is seen from L2 through L4. Otherwise, bone marrow signal intensity is within normal limits. The visualized spinal cord and conus demonstrate normal signal intensity and morphology. Details pertaining to the cauda equina will be discussed below.All the intervertebral discs demonstrate loss of T2 signal. There is significant loss of disc height at L2-3 and L3-4 with less notable loss of height at other levels. Additional level specific findings are as follows:T11-12: As seen on sagittal images, mild bulging disc and superimposed right foraminal protrusion resulting in moderate right foraminal narrowing.T12-L1: Unremarkable.L1-2: Facet hypertrophy with small effusions. Ligamentum flavum thickening. Bulging disc with a superimposed right foraminal and far lateral protrusion. Mild generalized spinal canal stenosis. Moderate right foraminal narrowing. L2-3: Facet hypertrophy. Ligamentum flavum thickening. Bulging disc. Moderate generalized spinal canal stenosis with slight crowding of the cauda equina. Moderate left and mild right foraminal narrowing. L3-4: Facet hypertrophy. Ligamentum flavum thickening. Bulging disc. Moderate generalized spinal canal stenosis with slight crowding of the cauda equina. Moderate left and mild right foraminal narrowing. L4-5: Facet hypertrophy with minimal effusions. Ligamentum flavum thickening. Posteriorly projecting facet synovial cyst on the left. Severe generalized spinal canal stenosis with crowding and possible impingement of the cauda equina. Moderate left and mild right foraminal narrowing. L5-S1: Marked facet hypertrophy with effusions. Ligamentum flavum thickening. Disc bulging. Severe generalized spinal canal stenosis with slight crowding of the cauda equina. Moderate bilateral foraminal narrowing.
Moderate to severe degenerative disease is seen at multiple levels in the lumbar spine. Fairly significant spinal canal stenosis is seen from L2-3 through L5-S1 with nerve root crowding and impingement as discussed above. Scattered mild-to-moderate foraminal narrowing is also demonstrated.