Female, 72 years old, with leg and hip pain. Grade 1/2 anterolisthesis of L4 relative to L5 is unchanged. Spinal alignment is otherwise unremarkable.Vertebral body morphology is within normal limits. No concerning marrow replacement or marrow edema is seen.The visualized spinal cord, conus, and nerve roots of the cauda equina are unremarkable except as discussed below.T12-L1: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. Mild generalized spinal canal stenosis. No significant neuroforaminal narrowing. No significant interval changes.L1-2: Moderate facet hypertrophy and ligamentum flavum thickening. Minimal bulging disk. No significant generalized spinal canal stenosis or neuroforaminal narrowing. No significant interval changes. L2-3: Marked left and moderate right facet hypertrophy. Ligamentum flavum thickening. Minimal bulging disk. No significant generalized spinal canal stenosis or neuroforaminal narrowing. No significant interval changes. L3-4: Marked facet hypertrophy and ligamentum flavum thickening. Minimal bulging disk with a small superimposed central disk extrusion. No significant generalized spinal canal stenosis. Mild bilateral foraminal narrowing. No significant interval changes.L4-5: Marked facet hypertrophy and ligamentum flavum thickening. Disk uncovering and disk bulging. A superimposed central disk protrusion seems to be slightly larger with increase in the moderate to severe spinal canal stenosis. A right foraminal disk protrusion also seems to be mildly larger with a greater degree of herniation into the vertebral body. Significant narrowing of the right neural foramen with likely impingement potentially is also increased slightly. The left neural foramen remains mildly narrowed similar to prior. L5-S1: Moderate facet hypertrophy. T1/T2 hyperintensity in the disk may reflect disk mineralization or proteinaceous degeneration. Disk bulging and a superimposed central/left paracentral disk extrusion are not significantly changed. Mild effacement of the left ventral thecal sac is unchanged. Mild bilateral foraminal narrowing. No significant interval changes.
1. Multilevel degenerative findings, most severely affecting the L4-5 level. Spondylolisthesis, along with a mildly progressing central disk protrusion at this level, results in a moderate-severe spinal canal stenosis, slightly worse from prior. A right foraminal protrusion at this level is also slightly worse along with resultant severe narrowing of the right L4-5 neural foramen and probable nerve root impingement.2. Less severe degenerative findings are seen at other levels as detailed above without significant change.