64-year-old woman with recurrent herniated disks in the lumbar spine with sudden recurrence leg, buttock, and back pain. She has a history of L4-5 fusion and L5-S1 microdiscectomy. There are five lumbar type vertebral bodies are present. There is mild retrolisthesis of L5 on S1 and straightening of the normal lumbar lordosis. Vertebral body heights are well-maintained. There are postoperative changes of L4-5 fusion and laminectomy which appear unchanged. At L5-S1 there are findings compatible with interval surgery likely correlating with microdiscectomy. No focal marrow signal abnormality is appreciated. The conus medullaris terminates at L1. A prominent Schmorl's node is noted at T12.T12-L1 and L1-L2: There is no significant compromise to spinal canal or neural foramina.L2-L3: Mild laterally bulging disc and very mild bilateral neural foraminal narrowing which does not appear significantly changed.L3-L4: There is diffuse disc bulge, facet joint hypertrophy and ligamentum flavum thickening resulting in mild left and moderate right neural foraminal narrowing and mild to moderate spinal canal stenosis.L4-5: Status post L4-5 laminectomy, posterior fusion and placement of interbody cage device. The spinal canal is widely patent and there is no significant compromise to the neural foramina.L5-S1: Persistent left paracentral zone disc protrusion appears broader than on the prior exam. Disc bulge, facet joint hypertrophy, and ligamentum flavum thickening with mild spinal canal narrowing and severe bilateral neural foraminal narrowing.Simple appearing cysts are seen in the left kidney. There is mild atrophy of the paraspinal muscles.
1.Status post L4-5 laminectomy and fusion.2.Status post L5-S1 discectomy with residual/recurrent left paracentral disc protrusion. There is severe bilateral neural foraminal narrowing and mild spinal canal stenosis at this level.