Female, 80 years old, with chronic low back pain and sciatica. Grade 1 anterolisthesis is seen of L3 relative to L4, L4 relative to L5, and L5 relative to S1. Vertebral body heights are preserved. Degenerative endplate edema is seen at L4-5. Otherwise, no concerning marrow replacement or marrow edema is demonstrated.The visualized distal spinal cord and conus are within normal limits. The cauda equina nerve roots are discussed below.T12-L1: Facet arthropathy. Disc bulging. Mild spinal canal stenosis. Moderate bilateral foraminal narrowing.L1-2: Facet arthropathy. Minimal disc bulging. No significant spinal canal or foraminal stenosis. L2-3: Marked facet arthropathy with facet effusion on the right. Ligamentum flavum thickening. Disc bulging. Mild spinal canal stenosis. Moderate bilateral foraminal narrowing. L3-4: Marked facet arthropathy. Ligamentum flavum thickening. Disc bulging with vacuum phenomena and a superimposed central superiorly directed extrusion. Severe spinal canal stenosis with effacement of CSF and crowding/impingement of the cauda equina. Moderate left and mild right foraminal narrowing. L4-5: Marked facet arthropathy with bilateral effusions. Ligamentum flavum thickening. Disc bulging. Moderate spinal canal stenosis with crowding of the cauda equina. Moderate bilateral foraminal narrowing. L5-S1: Marked facet arthropathy. Disc bulging and annular fissuring. Moderate spinal canal stenosis. Mild bilateral foraminal narrowing. Multiple bilateral renal cystic lesions are seen including a large cystic lesion in the right upper pole.
Significant disc and posterior element degeneration is seen, particularly affecting L3-4 and L4-5 where there is significant spinal canal stenosis. Scattered mild-to-moderate foraminal narrowing is also demonstrated.