Female, 74 years old, with low back pain, possible SI joint arthropathy. A severe scoliotic curvature of the thoracic and lumbar spine is seen. Sagittal alignment is within acceptable limits.A slight left lateral loss of disc height is evident at the L3 level secondary to scoliosis. Otherwise, vertebral body heights are largely preserved.The visualized spinal cord and conus are unremarkable. The conus tip terminates at the L1 level which is within normal limits. The nerve roots of the cauda equina are unremarkable except as discussed specifically below.Severe degeneration and related endplate signal abnormality is demonstrated along L3-4 and to a lesser degree along L2-3. Additional level specific findings are as follows:T12-L1: Facet hypertrophy. Right far lateral disc osteophyte complex. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing.L1-2: Facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L2-3: Marked facet hypertrophy and ligamentum flavum thickening. Bulging disc. Mild generalized spinal canal stenosis with slight crowding of the cauda equina. Severe left and mild right foraminal narrowing. L3-4: Marked facet hypertrophy and ligamentum flavum thickening. Bulging disc. Severe spinal canal stenosis with crowding of the cauda equina. Severe bilateral foraminal narrowing. L4-5: Marked facet hypertrophy and ligamentum flavum thickening. Bulging disc. Severe spinal canal stenosis with crowding of the cauda equina. Severe right and moderate left foraminal narrowing. L5-S1: Marked facet hypertrophy and ligamentum flavum thickening. Bulging disc with a left subarticular/foraminal protrusion. Mild narrowing of the left lateral recess. Moderate left foraminal narrowing. Tarlov cysts are evident within the sacral spinal canal.
Severe disc and posterior element degeneration is seen likely secondary to a significant scoliotic deformity of the thoracolumbar spine. These findings result in severe generalized spinal canal stenosis at L3-4 and L4-5 with scattered severe foraminal narrowing as above.