 This exam is mildly degraded by motion artifact. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable. The imaged spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. The conus terminates at the inferior L1 endplate. There is evidence of prior surgery at the left L4-L5 and L5-S1 levels.L1-L2: No significant disc disease, spinal canal, or neural foraminal narrowing.L2-L3: There is disc desiccation and a mild disc bulge as well as mild facet arthropathy and ligamentum flavum thickening. No significant spinal canal or neural foramina stenosis.L3-L4: No significant disc disease, spinal canal, or neural foraminal narrowing. There is prominence of the epidural fat.L4-L5: There is disc desiccation, end plate degenerative change, and a disc bulge asymmetric to the left as well as mild facet arthropathy and ligamentum flavum thickening. These findings result in mild spinal canal stenosis including partial effacement of the left lateral recess. There is mild left foramina stenosis. The disc also likely contacts the exiting left L4 and possibly traversing left L5 nerve root. There is evidence of prior surgery at this level on the left.L5-S1: There are apparent postoperative findings related to left L5 hemilaminectomy. There is disc desiccation, mild loss of height, endplate degenerative change, and a disc bulge asymmetric to left with a superimposed left foraminal herniation. There is also prominent osteophyte component. There is also left facet arthropathy. These findings result in severe left neural foramen stenosis without significant spinal canal or right foramina stenosis.
1.Postoperative changes of prior surgery/laminotomies at the left L4-L5 and L5-S1 levels.2.L5-S1 herniation resulting in severe left neural foraminal narrowing at this level. There are disk and osteophyte components.3.Mild L4-L5 spinal canal stenosis. Remainder of the levels as detailed above.4.No evidence of traumatic compression fractures or epidural hematomas.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.