50 serial female with spinal fusion L4/L5 9/05. Continued low back pain.IMAGE ACQUISITIONS: Thoracic/lumbar spine CT without contrast Thoracic spine alignment is normal. No evidence of central canal or neuroforaminal stenosis.Lumber spine alignment is normal. There is fusion of L4 and L5 with bilateral intrapedicular screws.L1-2: No central canal or neuroforaminal narrowing.L2-3: Minimal right facet joint hypertrophy. No central canal or neuroforaminal stenosis.L3-4: Posterior disk bulge cause centrally and left laterally. Mild left neuroforaminal impingement and mild central canal narrowing.L4-5: L4 Intrapedicular screws and right laminectomy. There is effacement right lateral and anterior to the thecal sac which raises the question of epidural fibrosis. MRI with contrast can be used to further evaluate.L5-S1: L5 interpedicular screws. There is narrowing of the right neural foramen.
Postsurgical and degenerative changes as described above. There is question of right-sided epidural fibrosis at L4-5 for which MRI can be used to further evaluate.