Left lower extremity weakness. Evaluate for hematoma. Thoracic: There is mild loss of height/compression deformity involving the T7 vertebral body including Schmorl's node in its superior aspect, similar to prior and without evidence of edema. Thoracic vertebral body heights are otherwise maintained. Alignment is maintained with mild kyphosis with apex at the T7 level. Bone marrow signal is benign with no suspicious lesions. Mild degenerative changes are seen with trace disc bulges at the T7-T8 and T6-T7 levels with mild spinal canal stenosis at this level. No findings to suggest high-grade spinal canal stenosis at any level in the thoracic spine. Thoracic cord is normal in signal and contour. There is moderate left and mild right neural foraminal stenosis at the T10-T11 level. Remainder of the neural foramina are patent.Lumbar: Five lumbar type vertebral bodies are presumed to be present. Postsurgical changes of laminectomy and fusion are seen from L2 to L5 with posterior spinal fusion hardware and interbody spacers grossly appearing in adequate position. There is mild stenosis/effacement of the thecal sac at the L3-L4 and moderate at L4-L5 level which is suboptimally assessed due to artifact from the hardware. There is no higher grade spinal canal stenosis in the lumbar spine. No epidural hematoma is evident within the limitations of the artifact.Neural foramina also not well evaluated due to susceptibility artifact related to the pedicle screws. The bilateral L1-L2, L2-L3, and L5-S1 neural foramina are patent. Mild to moderate neural foraminal stenosis is suspected at L3-4 and L4-L5 related to mild disc bulge and facet arthropathy.Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. Paraspinous soft tissues demonstrate expected postsurgical changes without large fluid collections or hematomas.
1. Interval postsurgical changes of L2 to L5 lumbar fusion. No epidural hematoma is evident. 2. Compared to MRI from 4/29/2015, there appears to be some increased (mild to moderate) narrowing of the spinal canal at L3-L4 and L4-L5 levels related to combination of epidural fat, facet arthropathy, and congenital narrowing, with susceptibility artifact from hardware also contributing to the apparent worsened stenosis. Patient has had decompressive laminectomies at these levels previously. Mild to moderate neural foraminal narrowing at L3-L4 and L4-L5 is also suspected bilaterally but not well evaluated due to susceptibility artifact from the hardware.3. Mild spinal canal stenosis at the T7-T8 level related to combination of congenital narrowing, small disc bulge, and kyphosis. No high-grade spinal canal stenosis is evident. No cord signal abnormality. There is moderate left T10-T11 neural foraminal stenosis.