Male, 54 years old, with low back and bilateral leg pain. Alignment is anatomic. Vertebral body heights are preserved. The L5 vertebral body and the sacrum are relatively fatty replaced with a more heterogeneous mottled appearance of the remaining lumbar vertebral body levels. However, no evidence of marrow edema is seen. The visualized spinal cord, conus and cauda equina are unremarkable.T11-12: Ligamentum flavum thickening and facet hypertrophy. No significant spinal canal or neuroforaminal stenosis.T12-L1: Unremarkable.L1-2: Moderate left and mild right facet hypertrophy with ligamentum flavum thickening. Mild bulging disc. No significant spinal canal stenosis. Severe left and mild right foraminal narrowing. L2-3: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L3-4: Mild facet hypertrophy and ligamentum flavum thickening. Small left ligamentum flavum cyst which slightly indents the left dorsal thecal sac. No significant spinal canal or neuroforaminal stenosis. L4-5: Moderate facet hypertrophy. Small left ligamentum flavum cyst causing no significant deformation of the thecal sac. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L5-S1: Mild facet hypertrophy and ligamentum flavum thickening. Bulging disc with a small right paracentral and foraminal protrusion. No significant spinal canal stenosis. Moderate to severe right and moderate left foraminal narrowing.
1.No significant or high-grade spinal canal stenosis is seen.2.Posterior element hypertrophy at L1-2 causes a severe left and mild right foraminal narrowing.3.Posterior element hypertrophy and disc disease at L5-S1 causes a moderate to severe right and moderate left foraminal narrowing.4.Marrow signal characteristics are somewhat mottled and heterogeneous except at the L5 level and in the sacrum where the marrow is more uniformly fatty replaced. The etiology of this finding is uncertain, but no evidence of marrow edema is seen to suggest an active pathologic process.