Female, 49 years old, with lumbar spine tenderness to palpation, status post recent L4-5 epidural injection three days ago, elevated WBC count. Trace anterolisthesis of L4 on L5 and L5 on S1 is again seen, similar to prior. Sagittal alignment is otherwise unremarkable.Vertebral body morphology is within normal limits. No worrisome marrow replacement or evidence of significant marrow edema is seen.Advanced facet arthropathy is seen at L4-5 with facet effusions, and again at L5-S1. Mild edema is seen in the adjacent soft tissues.The visualized spinal cord, conus and cauda equina are within normal limits. No evidence of any epidural abnormality is seen, and in particular, there are no findings to suggest an epidural abscess or hematoma.L1-2: Mild facet hypertrophy and ligamentum flavum thickening. Minimal bulging disc. No significant spinal canal or foraminal stenosis. L2-3: Mild facet hypertrophy and ligamentum flavum thickening. Minimal bulging disc. No significant spinal canal or foraminal stenosis. L3-4: Moderate facet arthropathy with ligamentum flavum thickening. Minimal disc bulging. No significant spinal canal stenosis. Mild left foraminal narrowing. L4-5: Advanced facet arthropathy with ligamentum flavum thickening. Loss of disc height, disc bulging and disc uncovering. No significant spinal canal stenosis. Moderate left and mild right foraminal narrowing. L5-S1: Advanced facet arthropathy. Loss of disc height, disc bulging and disc uncovering with a small left foraminal annular fissure. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing.
1.No evidence of any epidural abscess or other acute epidural process.2.Trace spondylolisthesis of L4 on L5 and L5 on S1 is unchanged. No acute marrow abnormalities are detected.3.Advanced facet arthropathy is seen at L4-5 and L5-S1, similar to prior.4.Mild degenerative findings are evident at other levels but without significant spinal canal stenosis.