Back pain. Postoperative changes of a posterior laminectomy at L4 and L5.L1-2: Disk disease with posterior disk bulge. Bilateral facet hypertrophy. No significant central canal stenosis. L2-3: Posterior disk bulge, bilateral facet hypertrophy and thickening of the ligamentum flavum with mild narrowing of the spinal canal. Bilateral neuroforaminal narrowing. L3-4: Grade 1 retrolisthesis of L3 on L4. Degenerative disk disease is present. There are severe endplate changes and multiples lytic foci, very suspicious for a diskitis/osteomyelitis or metastatic disease. There is extensive soft tissue abnormality in the spinal canal and in paravertebral region, with involvement of neuroforamina. There is likely impingement of nerve roots within the spinal canal and right neuroforamen. Please correlate with a dedicated MRI of the lumbar spine.L4-5: Grade 1 retrolisthesis of L4 on L5 with degenerative disk disease including loss of disk height and posterior disk bulge / herniation. There is bilateral spinal canal and neuroforaminal narrowing, and likely nerve impingement.L5-S1: Grade 1 retrolisthesis of L5 on S1 with posterior disk bulge and bilateral neural foramen narrowing. There is extensive soft tissue abnormality in the spinal canal and neuroforamina, probably causing encasement or impingement of nerve roots.A small sclerotic lesion is seen in the left ilium. This likely represents an enostosis, but blastic bone metastasis can have similar appearance.
1.Degenerative disease of the lumbar spine as described above. Postoperative changes of posterior laminectomy extending at L4 and L5 level.2.There is extensive L3-L4 disk disease and endplate destruction with multiple lytic lesions, and extensive soft tissue abnormality within the spinal canal, neuroforamina and paravertebral region, very suspicious for discitis/osteomyelitis versus metastatic disease.3.Spinal canal and neuroforaminal narrowing at multiple levels.4.Small sclerotic lesion in the left ilium. This likely represents an enostosis, but blastic bone metastasis can have similar appearance.5.Findings were discussed with Dr. Pettit at time of final reporting of the study.