Back pain Five lumbar type vertebral bodies are presumed to be present with the most inferior well-defined disc space labeled L5-S1. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.Axial sequences are motion degraded slightly limiting evaluation. There are multilevel degenerative changes as detailed below. There is T1 and T2 hyperintensity involving the L5-S1 disc space which may be related to calcification. There is evidence of prior laminectomies at L4-L5 and L5-S1. There is ossification along the lateral aspects of the posterior elements from L4 to S1 presumably related to prior osseous fusion. CT may better assess the bony fusion mass.Multilevel degenerative changes are seen, as described below:L1-L2: Minimal disc bulge. No spinal canal or neural foraminal stenosis. Mild bilateral facet arthropathy.L2-L3: Minimal disc bulge. No spinal canal or neural foraminal stenosis. Mild bilateral facet arthropathy.L3-L4: Minimal disc bulge. There is moderate bilateral facet arthropathy. There is also ligamentum flavum thickening. Mild narrowing of the spinal canal including partial effacement of the posterior left lateral aspect of the thecal sac related to facet arthropathy. There is also mild narrowing of the bilateral neural foramina.L4-L5: Prior laminectomy. Bilateral facet arthropathy. Bony proliferation noted lateral to the facet joints. No spinal canal stenosis. No neural foraminal stenosis.L5-S1: Prior laminectomy. Bony proliferation noted lateral to the facet joints. No spinal canal stenosis. No neural foraminal stenosis.
1. Postsurgical changes compatible with remote L4-S1 laminectomy and fusion and can be correlated with history. CT or radiographs may be helpful to better assess the degree of fusion if clinically indicated.2. Mild spinal canal and mild bilateral neural foraminal narrowing at the L3-L4 level. Otherwise no spinal canal or neural foraminal stenosis is appreciated at any level.3. Moderate facet arthropathy at L3-L4 and to a lesser degree at additional levels as above and may be contributing to low back pain.