30-year-old male with history of L5-S1 herniation now with recurring back pain. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is loss of disc height at L5-S1. Alignment is within normal limits. A benign hemangioma or focal fat is present within the vertebral body of L1. There is degenerative signal abnormality at the inferior endplate of L5 and superior endplate of S1. The conus medullaris is normal in position terminating at the level of T12-L1. The paraspinous soft tissues are within normal limits.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: No significant disc disease. No spinal canal or neural foraminal stenosis.L5-S1: The previously seen large disc extrusion is no longer visualized. There is a residual disc bulge and a sequestered disc fragment measuring 1 cm craniocaudally within the ventral epidural space posterior to the mid L5 vertebral body. There is a shallow left paracentral protrusion which slightly narrows the nerve root sleeve of the descending left S1 nerve root. There is mild neuroforaminal narrowing, worse on the left. No significant spinal canal stenosis.
Previous L5-S1 disc extrusion no long visualized, although there is a residual disc bulge and a sequestered disc fragment measuring 1 cm craniocaudally within the ventral epidural space posterior to the middle aspect of the vertebral body of L5. There is a slight left paracentral protrusion component which narrows the descending left S1 nerve root sleeve. Overall, the appearance has improved when compared to the prior MRI.