 There is transitional anatomy with lumbarization of S1. As numbered previously, the last fully formed disc is at S1-S2.There are stable postoperative findings in the lumbar region related to resection of a previous left paraspinal mass including resection of the left paraspinal musculature. There is persistent laxity of the left posterior abdominal wall with partial herniation of the left kidney. There is no mass-like enhancement within the surgical bed or within the spinal canal. The cauda equina remains along the right aspect of the spinal canal, likely secondary to the scoliosis, which includes convex leftward lumbar curvature and a rightward thoracic curvature, better assessed on standing radiographs. Again seen is hypertrophy of the left lumbar posterior elements which is likely compensatory. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. No abnormal signal in the spinal cord. Conus terminates normally. Again seen is multilevel left-sided lumbar neural foraminal stenosis related to the hypertrophy of the posterior elements.
1. Stable postoperative findings in the left lumbar region without evidence of tumor recurrence. Would suggest obtaining both axial and sagittal post contrast sequences with fat saturation in the lumbar spine on next follow-up study.2. Again seen is scoliosis which is better assessed on prior serial thoracolumbar standing radiographs. There is significant left-sided neural foraminal stenosis throughout the lumbar spine related to hypertrophy of the posterior elements.