Back pain with radiculopathy, status post laminectomy Five lumbar type vertebral bodies are presumed to be present. Small Schmorl's nodes are noted involving the superior endplates of L1 and L2 vertebral bodies with mild anterior vertebral body wedging, without bone marrow edema to suggest a recent compression fracture. Vertebral body heights are otherwise within normal limits. There is some loss of lumbar lordosis. Alignment is otherwise within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.Postsurgical changes are evident including posterior spinal fusion hardware extending from L3 to S1 with pedicle screws and bilateral paraspinous rods. Interbody fusion device is also noted at the L3-L4 level. Note integrity of hardware can be better assessed with CT or radiographs, but appears grossly in adequate position. Spinal canal is surgically well decompressed at L3-L4, L4-L5, and L5-S1.Individual levels, as described below:T12-L1: Small disc bulge without significant spinal canal or neural foraminal stenosis.L1-L2: Small disc bulge, with ligamentum flavum thickening, and mild facet arthropathy result in mild narrowing of the spinal canal. Neural foramina are patent.L2-L3: Mild disc bulge, ligamentum flavum thickening, and facet arthropathy contribute to mild central spinal canal narrowing just above the level of the laminectomy. Neural foramina are patent.L3-L4: Spinal canal is well decompressed. Neural foramina also appear patent with susceptibility artifact from hardware slightly limiting examination. L4-L5: Spinal canal is well decompressed. Mild to moderate right neural foraminal stenosis is suspected related to endplate osteophytes and facet arthropathy. Minimal left neural foraminal narrowing. Small dorsal annular fissure.L5-S1: Spinal canal is well decompressed. Disc bulge with dorsal annular fissure and small protrusion. Mild to moderate right and mild left neural foraminal stenosis is suspected with susceptibility artifact from hardware limiting examination.
1. Postoperative changes as described above. Spinal canal is well decompressed at L3-L4, L4-L5, and L5-S1.2. There is mild spinal canal stenosis at L1-L2 and L2-L3. There is mild to moderate neural foraminal stenosis involving the right L4-L5 and right L5-S1 levels and to a milder degree at left L5-S1.