Lumbago with sciatica, right side [M54.41], Reason for Study: ^Reason: shooting pain down R later thigh to R lat foot past back surgery History: up For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. Previously seen central to left disc extrusion at the level of L5S1 appears to be lessen in terms of the degree of protrusion. However, small low signal intensity lesion which likely represent the disc material is seen on the left side lateral recess. Redemonstration of the prior L3 and L4 bilateral total laminectomies with screws and rods as well as spacers L34 and L45 intervertebral disc spaces.The vertebral body height is preserved. The signal of the visualized cord is normal. The conus medullaris terminates at the L1 level. The signal intensity of vertebral bodies are within normal limits. L12: broad based central to left disc protrusion abutting thecal sac, no change since prior scan.L23: No discrete herniation, canal stenosis, or neural foraminal narrowing. Mild disk desiccation. No change since prior scan.L34: No disk herniation, canal stenosis, or neural foraminal narrowing. No change since prior scan.L45: No disk herniation, canal stenosis, or neural foraminal narrowing.L5S1: Small low signal intensity lesion on the left lateral recess but not directly compressing the left side nerve root or evidence of thecal sac compression. This could represent possible residual disc material or postoperative changes.
1. Interval decreased extent of the L5S1 disc extrusion as described above with remained small low signal intensity lesion likely represent residual disc material vs postoperative changes.2. No evidence of new disc herniation or neural foraminal stenosis.3. No change of postoperative status of L3,L4 bilateral total laminectomies since prior scan.