Lumbar radiculopathy, with now increasing left leg pain with numbness. History of recent right-sided L3-4 foraminotomy and microdiskectomy for lumbar radiculopathy, as well as minimally invasive left L5-S1 hemilaminotomy and diskectomy and bilateral laminectomy at L4-L5 in 2005. There are interval postoperative findings related to right L3 foraminotomy and microdiskectomy, with enhancement in the paraspinal tissues along the surgical approach and in the right L3-4 neural foramen, with improved patency of the right aspect of the spinal canal at this level. However, there is persistent mild disc bulge, left ligamentum flavum thickening, and bilateral facet joint hypertrophy with moderate narrowing of the right L3-4 neural foramen, beyond the effects of granulation tissue, and effacement of the left lateral recess at L3. There are remote postoperative findings at L4-5 and L5-S1 with a persistent disc bulge, bilateral ligamentum flavum thickening, and facet hypertrophy with associated mild bilateral L4-5 and right L5-S1 neural foramen stenosis, but severe left L5-S1 neural foramen stenosis, as well as moderate spinal canal stenosis at these levels. There is also trace retrolisthesis of L5 on S1. There is no significant spinal canal or neural foraminal stenosis in the upper lumbar spine. The vertebral body heights are preserved. Aside from degenerative bone marrow signal alterations at L5-S1, the vertebral bone marrow appears unremarkable. The imaged portions of the spinal cord are unremarkable.
1. Interval postoperative findings related to right L3 foraminotomy and microdiskectomy, with enhancement in the paraspinal tissues along the surgical approach and improved patency of the right aspect of the spinal canal at this level. However, there is persistent mild disc bulge, left ligamentum flavum thickening, and bilateral facet joint hypertrophy with moderate narrowing of the right L3-4 neural foramen and effacement of the left lateral recess at L3. 2. Remote postoperative findings at L4-5 and L5-S1 with a persistent disc bulge, bilateral ligamentum flavum thickening, and facet hypertrophy with associated mild bilateral L4-5 and right L5-S1 neural foramen stenosis, but severe left L5-S1 neural foramen stenosis, as well as moderate spinal canal stenosis at these levels. 