Female, 90 years old, with left gluteal and leg pain, worse at the posterior coccyx. A mild levocurvature of lumbar spine may be positional. Sagittal alignment is unremarkable. Vertebral body heights are preserved. Mild endplate edema is seen along the superior L2 endplate. Fatty degenerative endplate signal change is noted at L3-4 and L4-5.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable except as discussed below.L1-2: Minimal disc bulging. No significant spinal canal or foraminal stenosis. L2-3: Minimal disc bulging. Small right foraminal protrusion. No significant spinal canal or foraminal stenosis L3-4: Mild facet arthropathy and ligamentum flavum thickening. Bulging disc asymmetric to the right. Narrowing of the right lateral recess but no significant generalized spinal canal stenosis. Moderate right foraminal narrowing. L4-5: Moderate facet arthropathy and ligament thickening. Bulging disc. Moderate generalized spinal canal narrowing with some crowding of the cauda equina. Severe right and mild left foraminal narrowing. L5-S1: Facet arthropathy. Central and left paracentral disc protrusion. The left lateral recess is significantly narrowed, though there is no generalized spinal canal stenosis. Severe left foraminal narrowing.
Multilevel disc degeneration is seen. Most notably, at L3-4 there is a moderate generalized spinal canal stenosis and severe right foraminal narrowing; and at L5-S1, there is significant narrowing of the left lateral recess and severe left foraminal narrowing.