Reason: evaluate for causes of back pain History: worsening back pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. A 1 cm lesion within the left half of the L5 vertebral body along its superior aspect is stable when compared to the prior exam it is bright on T1 and T2 imaging and most likely represents an atypical vertebral body hemangioma.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is moderate bilateral facet hypertrophy present at this level associated with some narrowing of the neural foramina left worse than right.At L4-5 there is no significant compromise to spinal canal or neural foramina. Since the prior exam the patient has undergone left-sided hemilaminotomy compared a left-sided ligamentum flavum cystic lesion as been removed. There is marked bilateral facet hypertrophy at this level associated with ligamentum flavum hypertrophy,a disk bulge, disk desiccation and mild loss of disk space height.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.Two cystic lesions along the right kidney are stable when compared to the prior exam and measure up to 12 mm in diameter.
1.Since the prior exam cystic lesion adjacent to the left L4-5 facet joint has been removed. The patient is status-post left-sided hemilaminotomy at this level.2.There are degenerative changes present in the lower lumbar spine mainly in the form of facet hypertrophy.3.Stable right kidney cystic lesions (most likely simple cysts)4.A 10 mm L5 vertebral body lesion is stable in size since 2010 . It is most likely benign.