Lumbar back pain
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There is a grade I anterior spondylolisthesis of L4 with respect to L5 secondary to degenerative facet joint changes. No definite pars defects. Alignment of the lumbar spine is otherwise unremarkable.
From the L4 to the S2 segment there is severe epidural lipomatosis contributing to thecal sac distortion and stenosis.
This case elegantly illustrates compression of the thecal sac into various configurations due to the variable location and number of epidural ligaments.
Case courtesy of A/Prof DL Stella, Royal Melbourne Hospital.