Male, 75 years old, with low back pain status post L4-5 surgery. The lumbar lordosis is straightened, but sagittal alignment is otherwise unremarkable. Vertebral body height and morphology are within normal limits. No pathologic marrow replacement or marrow edema is seen.The visualized distal spinal cord, conus and cauda equina are unremarkable. No epidural abnormalities are suspected.Postoperative findings are seen at the L4-5 level including partial spinous process resection and probable laminectomy and thickening of the ligamentum flavum.Loss of disc height is evident at L2-3 and L4-5. With the exception of L1-2, all of the lumbar discs demonstrate loss of T2 signal. Additional level specific findings are as follows:L1-2: Unremarkable. L2-3: Mild disc bulging. No significant spinal canal narrowing. Mild bilateral foraminal narrowing. No interval changes.L3-4: Facet hypertrophy and ligamentum flavum thickening. Minimal disc bulging. No significant spinal canal narrowing. Mild bilateral foraminal narrowing. No interval changes. L4-5: Facet arthropathy. Mild disc bulging. No spinal canal stenosis. Severe right and moderate left foraminal narrowing. No interval changes. L5-S1: Facet arthropathy and ligamentum flavum thickening. Disc bulging and left paracentral annular fissuring. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing. No interval changes.
1.Relatively mild degenerative findings with no significant interval change. 2.There are no areas of high-grade spinal canal stenosis, though there is a severe narrowing of the right L4-5 neural foramen.3.Postoperative findings at L4-5 appear similar to the prior examination.