Reason: low back pain, R side flank pain, s/p spinal surgery History: as above Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. The patient is status post left-sided hemilaminectomy at L5-S1.At L5-S1 there is loss of disk space height, disk desiccation and diffuse disk bulge associated with bilateral neural foramina narrowing and partial effacement of the fat surrounding the left sided exiting nerve roots. There is effacement of the fat of the left lateral recess.At L4-5 there is loss of disk space height, diffuse disk bulge, disk desiccation and ligamentum flavum hypertrophy. Effacement of the fat of the left lateral recess at this level. The exiting nerve roots within the neural foramina are surrounded by fat,At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is a cystic lesion present in the right kidney could represent a simple cyst. Please refer to abdomen CT from 2/14/15 for further comments.
1.The patient is status post lumbar spine surgery in the lower lumbar spine. There is effacement of the fat of the left lateral recess at L5-S1 and L4-5. Differential considerations include scar formation as well as disk protrusion affecting the nerve roots at the left lateral recess at these levels. A contrast enhanced exam may help differentiate2.is encroachment of the exiting nerve roots within them left neural foramen at L5-S1 as a result of disk material