 Thoracic spine:Postoperative changes are noted from T2 through T4 including T3 and T4 laminectomies. At the T3/4 level, the thoracic cord narrows, and changes course from midline to anterolateral abutting the dura, and then resuming a more normal midline course at the T4/5 level with resumption of anteriorly located CSF. The cord maintains a normal intensity signal appearance.Mild anterior wedge deformity is noted of T8 and T9 without marrow edema consistent with chronic deformity.T1/2 demonstrates no significant disc bulge or cord encroachment.T2/3 demonstrates no significant disc bulge or cord encroachment. T3/4 demonstrates no significant disc bulge or cord encroachment. T4/5 demonstrates no significant disc bulge or cord encroachment. T5/6 demonstrates no significant disc bulge or cord encroachment.T6/7 demonstrates no significant disc bulge or cord encroachment. T7/8 demonstrates no significant disc bulge or cord encroachment. T8/9 demonstrates no significant disc bulge or cord encroachment. T9/10 demonstrates a small left paracentral disc extrusion that extends below the disc level without significant associated mass effect or stenosis.T10/11 demonstrates no significant disc bulge or cord encroachment. T11/12 demonstrates no significant disc bulge or cord encroachment. T12/L1 demonstrates mild disc bulge without cord encroachment. Lumbar spine:Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The visualized intra-abdominal and paraspinal contents are unremarkable.The conus terminates at L1/2 and is normal in signal and morphology. Upon prone maneuvering, the conus and cauda equina translate anteriorly.L1/2: UnremarkableL2/3: Asymmetric bulge to left causing mild left neural foraminal stenosis.L3/4: Diffuse annular disc bulge, ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is mild bilateral lateral recess and mild bilateral neural foraminal stenosis.L4/5: Small left paracentral disc protrusion, superimposed asymmetric bulge to the left, ligamentum flavum thickening, moderate left facet hypertrophy, and mild right facet hypertrophy. There is mild left lateral recess, moderate left neural foraminal, and mild right neural foraminal stenosis.L5/S1:Right paracentral disc protrusion, diffuse annular disc bulge, ligamentum flavum thickening, severe bilateral facet hypertrophy, and bilateral facet effusions. Bilateral S1 nerve root sheath origins are abutted, with flattening noted on the left, and flattening with compression noted on the right. There is moderate left neural foraminal and mild-to-moderate right neural foraminal stenosis.
1.At the T3/4 level, the thoracic cord narrows, and changes course from midline to anterolateral abutting the dura, and then resuming a more normal midline course at the T4/5 level with resumption of anteriorly located CSF. The cord maintains a normal intensity signal appearance. Given the short segment nature of the cord narrowing and course variance resulting in the appearance of a "kink", this may suggest a dural defect possibly with cord herniation.2.L2/3: Mild left neural foraminal stenosis.3.L3/4: Mild bilateral lateral recess and mild bilateral neural foraminal stenosis.4.L4/5: Mild left lateral recess, moderate left neural foraminal, and mild right neural foraminal stenosis.5.L5/S1:Bilateral S1 nerve root sheath origins are abutted, with flattening noted on the left, and flattening with compression noted on the right. There is moderate left neural foraminal and mild-to-moderate right neural foraminal stenosis.