Female, 76 years old, with persistent low back pain with radiation. A grade 1 anterolisthesis of L4 relative to L5 is demonstrated. Spinal alignment is otherwise unremarkable.Schmorl's node deformities are present at L3-4. Vertebral body morphology is otherwise within normal limits. No evidence of concerning marrow replacement or marrow edema is demonstrated.The visualized spinal cord, conus and cauda equina are within normal limits except as discussed below.T11-12: As visualized on sagittal images only, mild bulging disc with mild foraminal narrowing but no significant spinal canal stenosis.T12-L1: Unremarkable.L1-2: Unremarkable. L2-3: Unremarkable. L3-4: Mild facet hypertrophy. Minimal bulging disc. No significant spinal canal or neuroforaminal stenosis. L4-5: Severe facet hypertrophy with ligamentum flavum thickening. Disc bulging and disc uncovering. Moderate to severe generalized spinal canal stenosis with crowding of the cauda equina. Moderate right and mild left foraminal narrowing. L5-S1: Moderate facet hypertrophy. Mild bulging disc. No significant generalized spinal canal stenosis. Severe right and moderate left foraminal narrowing.
Disc degeneration at L4-5 with disc bulging and uncovering, in combination with marked posterior element hypertrophy, result in a significant spinal canal stenosis with crowding of the cauda equina.Moderate right and mild left foraminal narrowing at L4-5, with severe right and moderate left foraminal narrowing at L5-S1.