Female, 59 years old, with chronic low back pain radiating to the feet, unrelieved by physical therapy. A slight levocurvature of the lumbar spine is seen which may be positional. Sagittal alignment is unremarkable. Vertebral body height and morphology are within normal limits. No concerning marrow replacement or marrow edema is seen.The visualized distal spinal cord and conus demonstrate normal morphology and signal characteristics. The conus tip terminates at the L2 level which is within normal limits. Fatty infiltration of the filum terminale is demonstrated. No epidural abnormalities are suspected.L1-2: Unremarkable. L2-3: Mild facet arthropathy. Minimal disc bulging. No significant spinal canal stenosis. Mild left foraminal narrowing. L3-4: Facet arthropathy and ligamentum flavum thickening, right greater than left. Mild disc bulging with a small superimposed left foraminal protrusion which does not impinge on the exiting nerve root. Mild generalized spinal canal narrowing to which prominent dorsal epidural fat contributes. Moderate right and mild left foraminal narrowing. L4-5: Marked right facet arthropathy. Moderate left facet arthropathy. Ligamentum flavum thickening. Mild bulging disc. Mild to moderate generalized spinal canal narrowing with some degree of crowding of the cauda equina. Mild bilateral foraminal narrowing. L5-S1: Moderate bilateral facet arthropathy. Ligamentum flavum thickening. Disc bulging. Moderate generalized spinal canal narrowing. Severe left foraminal narrowing with probable nerve root impingement. Mild right foraminal narrowing.
Multilevel disc and posterior element degeneration is seen. A mild narrowing of the spinal canal is present at L3-4, with moderate narrowing and some degree of cauda equina crowding at L4-5.Moderate right foraminal narrowing is seen at L3-4. Severe left foraminal narrowing with probable nerve root impingement is seen at L4-5. Marked facet arthropathy is evident on the right at L4-5.Fatty infiltration of the filum terminale is seen. This can be an incidental finding in adults, particularly in the absence of additional imaging and clinical evidence of tethered cord.