 The last formed disk space is referred to as L5-S1, consistent with prior exam. There are immediate postoperative findings related to interval L1 -- L5 interbody fusion via lateral retroperitoneal approach with placement of disk spacer devices, paravertebral swelling and edema as well as edema in the disk spaces and the endplates of L4 vertebral body. There is edema in the interspinous spaces of L3-4 and L4-5. The osseous marrow signal is heterogeneous and benign. There is relative improvement in lumbar levoscoliosis which can be further assessed with standing radiographs. There is degeneration of essentially all lumbar disks with severe loss of disk height, with improvement status post interbody fusion. The conus terminates at L1-2.T12-L1: Disk bulge and mild right facet arthropathy which in combination with scoliosis results in moderate to severe right neural foraminal stenosis and mild effacement of the thecal sac on the right with no significant spinal canal or left neural foraminal stenosis.L1-2: Mild right facet arthropathy, posterior longitudinal ligament thickening with ligamentum flavum thickening causing moderate right neural foraminal stenosis and no significant spinal canal or left neural foraminal stenosis.L2-3: Severe right and moderate left facet arthropathy with ligamentum flavum thickening, and disk bulge causing mild spinal canal stenosis and mild right neural foraminal stenosis.L3-4: Severe bilateral facet arthropathy, ligamentum flavum thickening, and associated severe spinal canal stenosis and moderate bilateral neural foraminal stenosis.L4-5: Severe left facet arthropathy and associated ligamentum flavum thickening as well as disk bulge causing moderate spinal canal stenosis and moderate left neural foraminal stenosis. No significant right neural foraminal stenosis.L5-S1: Severe bilateral facet arthropathy causing mild right and modearate left neural foraminal stenosis and mild spinal canal stenosis.Overall, the degree of neural foraminal stenoses have perhaps mildly decreased from the prior myelogram of the postsurgical levels, although differences in imaging modalities limits more definitive evaluation.
1. Expected immediate postoperative findings related to L1-5 XLIF with interbody cages appearing well-positioned as seen on CT. No large paraspinous hematomas. 2. There is relative improvement in degenerative lumbar levoscoliosis. There is some improvement in neural foraminal stenoses, although differences in technique limit comparison with prior CT myelogram. Individual levels as above including severe L3-L4 and moderate L4-L5 spinal canal stenosis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.