Worsening back pain. Check construct. Postoperative day # 2. For the purpose of labeling, 5 lumbar vertebral bodies are assumed to be present.There are postsurgical changes, with air within L2 -- L3 and L3 -- L4 intervertebral disk spaces, and within the spinal canal. There are interspinous device, extending from L2 to L4 spinous processes. The surgical hardware appears intact. There are streak artifacts in the vicinity of the hardware, which limits evaluation of these areas. Soft tissue stranding and a small amount of fluid density are seen in the posterior subcutaneous soft tissues, which are compatible with expected postsurgical changes. There is effacement of epidural fat at the level of L2 -- L3 to L3 -- L4 levels, likely related to the postsurgical change, but given this, the spinal canal cannot be assessed adequately. At L4 -- L5 intervertebral level, there is residual disk bulging, facet arthropathic change and ligamentum flavum hypertrophy, resulting in residual spinal canal narrowing. These findings may be further evaluated with MRI of the lumbar spine.No acute fracture is identified.There is air in dilated small bowel loops, suggesting ileus.
1. Post surgical changes, with interspinous device extending from L2 to L4 levels. 2. Due to effacement of the epidural fat, and presence of streak artifacts, spinal canal from L2 -- L3 to L3 -- L4, cannot be adequately evaluated.3. Residual degenerative changes.4. MRI of lumbar spine may be helpful for further correlation.5. Dilated small bowel loops suggestive of ileus.