Evaluate for spondylolysis: low back pain for years worse with arching; x-ray with possible spondylolysis. There perhaps mild sclerosis in the region of the left L5 pars interarticularis. The vertebral column alignment is within normal limits and there is no evidence of bone marrow edema. The vertebral body heights are preserved. There is mild loss of disc space height at L5-S1, but no significant disc bulge, spinal canal stenosis, or neural foraminal stenosis. The spinal cord and cauda equina nerve roots display normal signal and morphology. The paravertebral soft tissues are unremarkable.
Perhaps mild sclerosis in the region of the left L5 pars interarticularis, which may represent chronic spondylolysis, but no evidence of spondylolisthesis or vertebral bone marrow edema. However, MRI generally has limited sensitivity for chronic spondylolysis otherwise and a focused lower lumbar CT may be useful for further evaluation.