Female, 67 years old, with right lower back pain. Image quality is degraded by motion artifact. Within this limitation, there may be mild endplate enhancement at T11-12, likely degenerative in nature. No other areas of pathologic marrow enhancement are seen. Mild enhancement of the facets and the ligamenta flava are noted in the lower lumbar region. No pathologic intradural enhancement is suspected. Vertebral body heights are preserved. There is a grade 1 anterolisthesis of L4 relative to L5. Sagittal alignment is otherwise unremarkable.At L1-2, there is a bulging disc asymmetric to the right. No significant spinal canal stenosis. Possible mild right foraminal narrowing.At L2-3, no significant spinal canal or foraminal stenosis is seen.At L3-4, there is mild disc bulging but no significant generalized spinal canal stenosis. The ligamenta flava are thickened.At L4-5, disc bulging and a central disc protrusion are demonstrated. Facet arthropathy and ligamenta flava thickening is also seen. A moderate generalized spinal canal stenosis is noted with moderate left and mild right foraminal narrowing.L5-S1, mild disc bulging is seen without significant spinal canal stenosis. Facet arthropathy and ligamenta flava thickening is noted. Mild right foraminal narrowing is seen.
1.Endplate enhancement at T11-12 is favored to be degenerative in etiology. Enhancement of the facets and ligamenta flava in the lower lumbar spine is also likely degenerative. No pathologic intradural enhancement is seen.2.Disc and posterior element degeneration is seen at multiple levels as discussed above. L4-5 appears to be the most severely affected level where there is a moderate generalized spinal canal stenosis and at least moderate left foraminal narrowing.