Male, 62 years old, with back ache. Straightening of the lumbar lordosis is seen. Sagittal alignment is otherwise unremarkable.Vertebral body height and morphology are within normal limits. Marrow signal characteristics are unremarkable.The visualized spinal cord, conus and cauda equina are within normal limits.As visualized on the sagittal images only, thickening of the right ligamentum flavum at T10-11 is seen which may cause some mild canal narrowing.L1-2: Unremarkable. L2-3: Unremarkable. L3-4: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disc. No significant generalized spinal canal stenosis. No significant neuroforaminal narrowing. L4-5: Advanced facet degeneration bilaterally with effusions, right side greater than left. There is also a posteriorly directed extracanalicular synovial cyst on the right. Mild bulging disc. Narrowing of the lateral recesses. Moderate to severe bilateral foraminal narrowing. L5-S1: Advanced facet degeneration bilaterally. Mild bulging disc slightly asymmetric to the right. No significant spinal canal stenosis. Severe right and moderate to severe left foraminal narrowing.
Relatively mild degenerative disc disease is seen without high-grade spinal canal stenosis.More notable is the presence of advanced facet degeneration at L4-5 and L5-S1. These changes contribute to significant neuroforaminal narrowing at these levels.