Female, 29 years old, with low back pain, possible herniated disk. The L5 vertebral body demonstrates a lumbosacral transitional morphology. Vertebral morphology is otherwise typical and unremarkable. No evidence of concerning marrow replacement or marrow edema is seen.The conus tip terminates at the L1 level which is normal. The visualized spinal cord and conus as well as the nerve roots of the cauda equina are unremarkable. The lower lumbar spinal canal is very capacious, perhaps even a bit ectatic. Large perineural root sleeve cysts are evident within the lower sacral canal and along the sacral foramina.The intervertebral disks demonstrate normal height and signal.From T12-L1 through L3-4, there is no evidence of significant disk herniation, spinal canal stenosis or neuroforaminal narrowing. L4-5, there may be mild disk bulging without significant spinal canal or neuroforaminal stenosis.At L5-S1, there is no evidence of significant disk disease or spinal canal stenosis. A perineural root sleeve cyst occupies the right L5-S1 neural foramen, but the neural foramina are otherwise patent.
1. At most, minimal disk bulging is seen at L4-5. At no level is there any significant spinal canal or neuroforaminal stenosis.2. Multiple large perineural root sleeve cysts are evident in the lower sacral spinal canal as well as the sacral neural foramina. These are a common incidental finding and are usually of no significance, but they can occasionally be symptomatic. Correlation with radicular type symptomatology is suggested.