Female, 61 years old, with low back pain. Image quality is degraded by motion artifact. Within this limitation, the following observations are made.Spinal alignment is anatomic. Vertebral body heights are preserved. Mild endplate edema is seen anteriorly at L2-3. No other significant or concerning marrow signal abnormality is seen.The visualized spinal cord and conus are unremarkable. Details of the cauda equina will be discussed by level as follows:L1-2: Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L2-3: Mild facet hypertrophy and ligamentum flavum thickening. Disc bulge asymmetric to the left foraminal and far lateral regions. Mild generalized spinal canal stenosis. Moderate left foraminal narrowing. L3-4: Moderate facet hypertrophy. Ligamentum flavum thickening. Bulging disc with mild to moderate generalized spinal canal stenosis. Moderate left foraminal narrowing. L4-5: Severe facet hypertrophy. Ligamentum flavum thickening. Bulging disc. Severe generalized spinal canal stenosis with crowding of the cauda equina. Moderate bilateral foraminal narrowing. L5-S1: Severe facet hypertrophy. Ligamentum flavum thickening. Mild generalized spinal canal stenosis. Moderate to severe right and mild left foraminal narrowing. Ill-defined STIR hyperintense signal is seen along the left prevertebral and periaortic soft tissues of uncertain significance. This is visualized only on sagittal STIR images and not well seen on the axial sequences.
1. Multilevel degenerative findings, most severely affecting the L3-4 level where there is a mild to moderate spinal canal stenosis, and at the L4-5 level where there is a severe spinal canal stenosis.2. Ill-defined abnormal signal is seen within the prevertebral and periaortic tissues on the left as visualized on sagittal STIR images. The significance of this finding is uncertain and it could even be technical in nature. If clinical concern warrants, dedicated abdominal imaging can be considered.