Male, 64 years old, with low back pain and some radiating symptoms. Trace anterolisthesis of L4 relative to L5 is seen. Spinal alignment is otherwise unremarkable. Vertebral body heights are preserved.Endplate edema is seen posteriorly at L3-4 in association with a disc extrusion at this level which may be partly intraosseous. Further details are discussed below. Mild endplate edema is seen at L2-3. No evidence of concerning marrow replacement is detected.The distal spinal cord and conus are within normal limits. No epidural abnormalities are suspected.L1-2: Unremarkable. L2-3: Loss of disc height and mild disc bulging. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L3-4: Facet arthropathy with small facet effusions. Disc bulging with a superimposed central and right paracentral superiorly directed extrusion. The extrusion encroaches upon the posterior inferior corner of the L3 vertebral body and may therefore be partly intraosseous. There is a severe associated spinal canal stenosis with effacement of CSF and crowding of the cauda equina. The left neural foramen is mildly narrowed. L4-5: Facet arthropathy with bilateral facet effusions. Disc bulging. A moderate spinal canal narrowing is seen mostly due to facet arthropathy. Mild right foraminal narrowing. L5-S1: Facet arthropathy right worse than left. The intervertebral disc is preserved. No significant spinal canal or foraminal stenosis.
Multilevel degenerative findings are seen. L3-4 is the most severely affected level where facet arthropathy and a disc extrusion contribute to produce a severe spinal canal stenosis. Elsewhere, no high-grade spinal canal or foraminal stenosis is seen.