L5-S1 microdiscectomy, evaluate for re-herniation. Recurrent lumbar radiculopathy down left lower extremity. Compared to 3/28/2015, interval postsurgical changes of microdiscectomy at the left L5-S1 level is seen via left-sided L5 laminotomy. Previously identified left paracentral disc extrusion at L5-S1 is no longer present. There remains moderate narrowing of the left L5-S1 neural foramen related to facet arthropathy, disc bulge, and endplate spur.There is unchanged mild retrolisthesis of L5 on S1 measuring approximately 5 mm. The vertebral body heights are well-maintained. There is disc desiccation of L3-L4, L4-L5 and L5-S1, which is unchanged. There is mild loss of disc height at L3-L4 and L4-L5 and moderate loss of disc height at L5-S1, which are similar to prior. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the L1-L2 level. Fatty filum is again demonstrated which measures less than 3 mm in thickness similar to prior.Individual levels as below: T12/L1: Bilateral facet degeneration, but no significant disc bulge, spinal canal or neural foraminal stenosis.L1/2: Bilateral facet degeneration, but no significant disc bulge, spinal canal or neural foraminal stenosis.L2/3: Bilateral facet degeneration, but no significant disc bulge, spinal canal or neural foraminal stenosis.L3/4: Mild disc bulge similar to prior, bilateral facet degeneration and ligamentum flavum thickening, but no significant spinal canal or neural foraminal stenosis.L4/5: Mild disc bulge, bilateral facet degeneration and ligamentum flavum thickening, contributing to mild spinal canal stenosis. No significant neural foraminal stenosisL5/S1: Postsurgical changes as described above. Previously seen left paracentral disc extrusion has been resected. There remains mild right and moderate left neural foraminal stenosis. Bilateral facet arthropathyPostsurgical changes involving the paraspinous soft tissues at L5-S1 without fluid collections. Paraspinous soft tissues are otherwise unremarkable.
Interval postsurgical changes of microdiscectomy with previously seen left paracentral disc extrusion at L5-S1 no longer present. No recurrent disc herniation in this location is evident. Again seen is moderate left-sided neural foraminal stenosis at L5-S1 related to facet arthropathy, disc bulge, and endplate spur with contact of the exiting left L5 nerve root. Additional levels as above.