Female, 60 years old, with severe back pain and difficulty with ambulation. A grade 1 retrolisthesis of L5 relative to S1 is seen, and there is also a grade 1 anterolisthesis of L4 relative to L5. Vertebral body heights are preserved. Marrow signal characteristics are within normal limits.The visualized distal spinal cord and conus are within normal limits. Details of the cauda equina are discussed below. Prominence of the dorsal epidural fat is seen beginning at T12 and continuing through L4. Otherwise, no epidural abnormalities are identified.T11-12 and T12-L1: Mild disc bulging. No significant compromise of the spinal canal or neural foramina.L1-2: Mild facet arthropathy. Ligamentum flavum thickening. Disc bulging. Mild spinal canal stenosis with slight crowding of the cauda equina. No significant foraminal narrowing. L2-3: Facet arthropathy. Ligamentum flavum thickening. Disc bulging with a right paracentral superiorly directed extrusion. Severe spinal canal stenosis with crowding and likely impingement of the cauda equina. Mild bilateral foraminal narrowing. L3-4: Facet arthropathy. Ligamentum flavum thickening. Disc bulging. Moderate spinal canal stenosis. Mild bilateral foraminal narrowing. L4-5: Advanced facet arthropathy. Disc bulging and disc uncovering. Severe spinal canal stenosis with crowding and probably impingement of the cauda equina. Mild bilateral foraminal narrowing. L5-S1: Evidence of left laminotomy is seen. Advanced facet arthropathy. Disc bulging and osteophytic ridging. Moderate spinal canal narrowing particularly affecting the left lateral recess where there may be a disc protrusion, scarring or focal osteophytic ridging. The left S1 nerve root is potentially impinged. Moderate bilateral foraminal narrowing.
Multilevel level disc and posterior element degeneration. This results in severe spinal canal stenosis at L2-3, moderate stenosis at L3-4, and severe stenosis at L4-5. At L5-S1, there is evidence of prior surgery. The left lateral recess is effaced with possible impingement of the S1 nerve root.