 There is unchanged minimal retrolisthesis of L5 relative to S1. The vertebral body heights are maintained. There is severe loss of intravertebral disc height at L5-S1. The distal spinal cord and conus demonstrate normal morphology and signal. T12-L1: There is no significant spinal canal or neural foraminal stenosis.L1-L2: There is no significant spinal canal or neural foraminal stenosis.L2-L3: There is a minimal disc bulge and facet hypertrophy bilaterally with minimal narrowing of the central canal, but no significant neural foraminal narrowing.L3-L4: There is a mild disc bulge and facet hypertrophy bilaterally with minimal narrowing of the spinal canal, but no significant neural foraminal narrowing.L4-L5: There are postsurgical findings related to left laminotomy and interval removal of synovial cyst. There is marked enhancement of the surgical wound track to the thecal sac predominantly on the left side and a fluid collection in the overlying subcutaneous tissues. There is also high T2 signal and enhancement in the right L4 and L5 pedicles and medial facets, which are hypertrophied. There is also a trace right facet effusion. There is a mild disc bulge and mildly prominent epidural fat result in mild spinal canal narrowing, which has improved from the prior study. There is also mild bilateral neural foraminal narrowing.L5-S1: There is a mild disc bulge and mildly prominent epidural fat without significant spinal canal stenosis or neural foraminal narrowing. However, there is right facet hypertrophy and a small joint effusion.
1. Postsurgical findings related to left L4-5 laminotomy and cyst removal, with a nonspecific posterior subcutaneous tissue fluid collection. The presence of enhancement tracking to the thecal sac may represent granulation tissue, although infection is a consideration based on imaging alone.2. Enhancement and edema in the medial right facets and pedicles of L4 and L5 may represent microfractures, degenerative effects, or perhaps an infectious process.3. Mild lower lumbar spine degenerative spondylosis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.