Female 48 years old Reason: Evaluate back hardware from surgery and spinal structure History: LBP with radiculopathy. The vertebral column alignment is within normal limits. There is mild developmental narrowing of the spinal canal with prominence of the dorsal epidural fat. The vertebral body and disc space heights are preserved with the exception of L5-S1. At L5-S1 there is complete loss of disc height as seen previously. There is a round low T1, high T2 focus in the posterior aspect of the L5 vertebral body, likely representing hemangioma, which is stable to slightly increased in size compared to the prior exam in 2013. Mild multilevel facet arthropathy. The vertebral bone marrow signal is otherwise unremarkable. Interspace observations:T12-L1: There is no significant compromise to spinal canal or neural foramina.L1-L2: There is no significant compromise to spinal canal or neural foramina.L2-L3: There is no significant compromise to spinal canal or neural foramina.L3-L4: There is no significant compromise to spinal canal or neural foramina.L4-5: There is no significant compromise to spinal canal or neural foramina.L5-S1: Evidence of a prior small right laminectomy. Within the L5 vertebral body is a lobulated lesion, which appears to be an atypical hemangioma. This lesion disrupts the posterior cortex of the vertebral body protruding posteriorly into the epidural space approximately 2 mm. Lesion is stable to minimally increased in size compared to prior exam There are posteriorly projecting endplate osteophyte without significant spinal canal stenosis at this level. Small right paracentral extrusion mildly narrows the right lateral recess and contacts the right S1 nerve root. The degree of narrowing is similar compared to prior exam in 2013. Bilateral facet arthropathy. Mild bilateral neural foraminal narrowing.
1.Degenerative and postsurgical changes of L5-S1 with complete loss of disc height, small right paracentral disc extrusion, and mild bilateral neural foraminal narrowing. There is no central canal stenosis and the overall appearance is not significantly changed.2.Lesion in the posterior L5 vertebral body likely represents an atypical hemangioma. This lesion disrupts the posterior cortex of the vertebral body and has mild epidural extension. This is stable to minimally increased in size compared to the prior exam.