Female, 53 years old, with neurogenic bladder, pain and right hip pain. Evidence of posterior instrumented fusion is seen from L4 through S1. Posterior spinal canal decompression also been performed at least at L4-5.Spinal alignment is anatomic. Vertebral body heights are preserved. Apart from the L4 through S1 vertebral bodies, which demonstrate largely fatty marrow signal likely related to surgical fusion, the vertebral body marrow signal is unremarkable. No definite pathologic marrow enhancement is seen.The visualized spinal cord and conus are within normal limits allowing for motion artifact. Evaluation of the spinal canal is slightly degraded through the operative region at L4 and L5, but no significant intrathecal abnormality is detected. No definite pathologic enhancement of the spinal cord or nerve roots is detected.Level specific degenerative findings are as follows:T12-L1: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis.L1-2: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. L2-3: Moderate facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. Mild spinal canal narrowing to which prominence of the dorsal epidural fat contributes. Moderate left and mild right foraminal narrowing. L3-4: Marked facet hypertrophy and ligamentum flavum thickening. Minimal bulging disk. Mild spinal canal narrowing to which prominence of the dorsal epidural fat contributes. Mild bilateral foraminal narrowing. L4-5: Hypertrophy of the residual facets. Partial fusion across the disk space with mild posterior osteophytic spurring asymmetric to the left. Partial left lateral recess effacement without significant generalized canal stenosis. Assessment of the neural foramina is complicated by metallic artifact, but moderate narrowing is suspected on the left. L5-S1: Facet hypertrophy. Disk space narrowing and minimal disk bulging. No significant canal stenosis. Assessment of the foramina is complicated by metallic artifact, but some degree of narrowing is suspected bilaterally. A left renal cystic lesion is identified incidentally.
1. Evidence of instrumented posterior spinal fusion from L4 through S1. The spinal canal has been decompressed posteriorly at least at L4-5.2. Relatively mild degenerative disk disease is seen at several levels. In combination with posterior element hypertrophy and prominence of the dorsal epidural fat, this contributes to mild spinal canal narrowing at L2-3 and L3-4.3. Moderate neuroforaminal narrowing is suspected on the left at L2-3 and L4-5. 