74-year-old female with a L2 radiculopathy. Evaluate for stenosis. Better seen on the recent lumbar CT are postsurgical changes of a spinal fusion at the L4-5 levels with bilateral pedicle screw fixation and paraspinous rods.The vertebral body heights are maintained. There is grade 1 retrolisthesis of L2 on L3. There is multilevel disc desiccation and disc height loss with multilevel endplate degenerative changes and Schmorl's nodes. The distal spinal cord and conus demonstrate normal signal in morphology. The paravertebral soft tissues are unremarkable.Degenerative changes are visualized in the lower thoracic spine with Schmorl's nodes and mild endplate degenerative changes at the T11-12 level.Degenerative changes are seen in the cervical spine as described below:T12-L1: Tiny disc bulge without spinal canal or neuroforaminal stenosis.L1-L2: Small disc bulge and mild facet arthropathy without spinal canal or neuroforaminal stenosis. L2-L3: Grade 1 retrolisthesis of L2 on L3 and facet arthropathy. Moderate to severe bilateral neural foraminal stenosis and mild to moderate spinal canal stenosis. There is soft tissue material effacing the right L2-3 foramen and the right L2-3 lateral recess. This material is adjacent to both the disc and the facet/ligamentum flavum.L3-L4, L4-5: Posterior spinal fusion hardware artifact precludes evaluation at this level.L5-S1: Full evaluation is limited by presence of hardware artifact. There does not appear to be significant spinal canal stenosis.
1.Postsurgical changes of a posterior spinal fusion at the L4-5 level. Note that hardware artifact limits evaluation from L3 through L5.2.Grade 1 retrolisthesis of L2 on L3 contributes to moderate to severe bilateral neural foraminal stenosis and mild to moderate spinal canal stenosis.3.Soft tissue material effaces the right L2-3 foramen and the right L2-3 lateral recess. This material may originate from the disc or the adjacent facet/ligament complex. This could represent a disc extrusion or sequestered disc, epidural scarring or an atypical synovial cyst.