Male, 51 years old, with low back pain for one year following motor vehicle accident. Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. Marrow signal characteristics are slightly heterogeneous but benign.Both facet joints are degenerated at L4-5. On the right, there is a facet effusion and evidence of edema within the right L5 pedicle and superior articulating facet, and within the right L4 pedicle and inferior articulating facet. There is a 1 mm focus of bright T2 signal within the right L5 pars interarticularis. However, no definite pars fracture is seen.The visualized distal spinal cord, conus and cauda equina nerve roots are within normal limits. No epidural abnormalities are suspected.L1-2 through L3-4: Unremarkable. L4-5: Moderately advanced facet degeneration as discussed above. Ligamentum flavum thickening. Mild disc bulging. No significant spinal canal stenosis. Moderate left and mild right foraminal narrowing. L5-S1: Moderately advanced facet degeneration. Bulging disc with a small right paracentral protrusion. No significant spinal canal or foraminal stenosis.
1.Moderately advanced facet degeneration at L4-5 and L5-S1. At L4-5 on the right, there is a facet effusion and evidence of edema affecting the pedicles and articulating facets. A small focus of intense T2 signal within the right L5 pars interarticularis could represent edema, a small cystic space or perhaps microtrabecular injury. These findings could potentially be posttraumatic, though osteoarthritic degeneration frequently produces identical findings.2.No other definite evidence of any post-traumatic lumbar spine abnormality is seen. No significant spinal canal or foraminal stenosis is detected.