Low back and leg pain. There are postoperative findings related to prior right hemilaminectomy at L3-4 and interval right L4-5 laminotomy with medial facetectomy and decompression, with mild edema in the paraspinal muscles along the surgical approach. There is multilevel degenerative spondylosis. At L1/2, there is a disc bulge with mild bilateral neural foraminal narrowing, but no evidence of spinal canal. At L2/3, there is a disc bulge with a left lateral disc protrusion, facet hypertrophy, and ligament flavum thickening that result in severe left neural foraminal narrowing. There is also mild right neural foraminal and mild spinal canal narrowing. At L3/4, there is a disc bulge with superimposed central protrusion, facet hypertrophy with effusions and left synovial cyst formation, and ligament flavum thickening that result in severe left lateral recess and neural foraminal narrowing and mild to moderate right neural foraminal narrowing. There is mild anterior subluxation of L3 on L4. At L4/5, there is left facet and ligamentum flavum hypertrophy and a prominent disc bulge that result in moderate to severe right and severe left neural foraminal narrowing, as well as mild spinal canal stenosis. There is also mild anterior subluxation of L4-L5 and irregularity of the superiroL5 endplate. At L5/S1, there is prominent bilateral facet hypertrophy with impingement upon the neural foraminal nerve roots, but no significant spinal canal stenosis. The imaged portions of the spinal cord are unremarkable.
Postoperative findings in the lumbar spine and extensive multilevel degenerative spondylosis with impingement upon neural foraminal nerve roots at the left L2/3, left L3/4, bilateral L4/5, and bilateral L5/S1 levels.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.