 The last well formed disk space is referred to as L5-S1. The osseous marrow signal appears benign but is mildly heterogeneous on T1 and T2 images. There is no osseous marrow edema. The vertebral body heights are intact. There is loss of T2 disk signal in the L3-4 and L4-5 disks with loss of disk height. There is mild grade 1 anterolisthesis of L4 on L5 with mild uncovering of the L4-5 disk. The conus terminates at the inferior aspect of L1 and has normal signal.T12-L1: No spinal canal or neural foraminal stenosis.L1-2: No spinal canal or neural foraminal stenosis.L2-3: No spinal canal or neural foraminal stenosis.L3-4: Minimal disk bulge and bilateral facet arthropathy with ligamenta flava thickening. Mild right neural foraminal stenosis. No significant spinal canal or left neural foraminal stenosis.L4-5: Mild disk bulge with uncovering of the disk secondary to anterolisthesis of L4 on L5. Moderate bilateral facet arthropathy and ligament flava thickening. Moderate to severe spinal canal stenosis and mild bilateral neural foraminal stenosis. There is mild soft tissue T2 hyperintense signal surrounding the facets of L4-5 probably representing mild reactive soft tissue edema from degenerative facets.L5-S1: Mild disk bulge with bilateral facet arthropathy and ligament flava thickening. Mild bilateral neural foraminal stenosis. No spinal canal stenosis.
Multilevel lumbar spondylosis worst at L4-5 where there is mild anterolisthesis of L4 on L5 with uncovering of the disk, facet arthropathy and ligamenta flava thickening combining to cause moderate to severe spinal canal stenosis and mild bilateral neural foraminal stenosis. 