Right buttock and perineal numbness and tingling Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is minimal anterolisthesis of L4 and L5 as seen before as well as minimal L1 on L2 retrolisthesis also as before. Alignment is otherwise maintained with preserved lordosis. Bone marrow signal is benign. The conus medullaris is normal in position. There is mild clumping of the cauda nerve roots from the L4 to L4-5 levels which also appears to be present previously and compatible with arachnoiditis.Again seen are postoperative changes of surgical fusion from L4 to L5 with bilateral paraspinous rods, pedicle screws, as well as interbody spacer at L4-L5 similar to prior. Since the prior MRI from 3/11/2016 interval decompressive laminectomy at L4-L5 has been performed with this level surgically well decompressed. Multilevel degenerative changes are seen as described below:At T11-T12, sagittal images demonstrate a mild disc bulge without significant spinal canal or neural foraminal stenosis. At T12-L1, there is a disc bulge eccentric to the right. There is mild right-sided facet arthropathy and ligamentum flavum thickening. There is mild right-sided neural foraminal stenosis and mild spinal canal stenosis.At L1-L2, there is mild disc bulge. There is mild facet arthropathy and ligamentum flavum thickening, contributing to overall mild central spinal canal stenosis, as well as mild to moderate right and minimal left foraminal narrowing. At L2-L3, is a stable trace disc bulge with rightward predominance and mild bilateral facet arthropathy as well as ligamentum flavum thickening. There is mild central spinal canal stenosis as well as mild mild bilateral neural foraminal stenosis.At L3-L4, there is a disc bulge eccentric to the left with effacement of the left lateral recess as well as moderate left-sided neural foraminal stenosis. Right neural foramen is patent. There is moderate bilateral facet arthropathy and ligamentum flavum thickening contributing to overall mild to moderate central spinal canal stenosis. At L4-L5, there is interval laminectomy with spinal canal now well decompressed. There is facet hypertrophy and disc uncovering with mild bulge. Neural foramina are suboptimally evaluated due to hardware however are grossly patent.At L5-S1, there is dorsal osteophyte formation without significant spinal canal stenosis. There is minimal narrowing of the neural foramina.
1. Since prior MRI from 3/11/2016, decompressive laminectomy at L4-L5 has been performed. This level is now well decompressed. There are multilevel degenerative changes throughout the lumbar spine which are not significantly changed in the interval with up to moderate left L3-L4 neural foraminal and left lateral recess stenosis, and no high-grade central spinal canal stenosis at any level. Additional details as above.2. There is mild clumping of the cauda equina nerve roots at the L4 level suggestive of arachnoiditis and grossly similar to prior.