Male, 59 years old, with lower back pain and left lower extremity pain. Trace retrolisthesis of L4 relative to L5 is demonstrated. Spinal alignment is otherwise unremarkable. Vertebral body heights are preserved. Marrow signal characteristics are unremarkable.The visualized spinal cord, conus and nerve roots of the cauda equina are unremarkable except as discussed below. No epidural abnormalities are suspected.L1-2 and L2-3: No significant spinal canal stenosis or neuroforaminal narrowing. L3-4: Mild facet hypertrophy and ligamentum flavum thickening. Loss of disc T2 signal, mild loss of disc height and mild disc bulging. Mild generalized spinal canal narrowing without nerve root impingement or crowding. Mild bilateral foraminal narrowing. L4-5: Moderate facet hypertrophy and ligamentum flavum thickening. Loss of disc height and T2 signal. Disc bulging with a superimposed central/left paracentral disc protrusion. Moderate to severe generalized spinal canal stenosis with crowding of the cauda equina nerve roots. Mild bilateral foraminal narrowing. L5-S1: Advanced facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or foraminal stenosis.
1.Disc degeneration at L4-5 with a central/left paracentral disc protrusion which causes a moderate to severe spinal canal stenosis and crowding of the nerve roots of the cauda equina.2.Relatively mild degenerative disc disease is seen at L3-4. Facet arthropathy is also noted at lower lumbar levels.