 Again seen is a T2 hyperintense, T1 hypointense, enhancing right paraspinal mass at the L1-L2 level which measures 3.2 x 2.8 x 7.9 cm and unchanged when remeasured on study from 12/3/2014. It completely fills and expands the right L1-L2 neural foramen but does not compress the thecal sac. It causes mild mass effect upon the smaller right kidney and mild remodeling of the right L2 transverse process.There is also unchanged additional enhancing mass in the right paraspinal muscles along the anterior lateral and lateral aspect of the L3 vertebral body which measures approximately 11 mm in thickness previously 10 mm. There is a component involving the right psoas muscle which is also similar. There is mild extension to involve the right lateral aspect of the L3-L4 neural foramen and abut the foraminal/extraforaminal L3 nerve root.There is also no significant change in mass along the right lateral aspect of the T12 vertebral body measuring 9 mm in thickness and approximately 3.7 cm in its long dimension.There is unchanged rightward displacement of the conus with suggestion of a CSF signal intensity rounded filling defect central to the surrounding slightly displaced nerve roots. There is also a thin linear focus of T1 hyperintensity anteriorly at the L2 level in a location where the cauda equina is displaced peripherally. These findings may be related to an arachnoid cyst versus adhesions/mild arachnoiditis.Additionally, there is T1 hyperintensity within the distal filum at the L5 level compatible with fibrofatty infiltration of the distal filum measuring less than 2 mm in thickness. The conus terminates normally at the L1-L2 level.The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The vertebral bone marrow signal is heterogenous but unchanged and may be related to post treatment change. There is an unchanged small central disc protrusion with associated disc desiccation at the L5-S1 level without spinal canal or neural foramen stenosis. Additionally, at L1-L2, there is disc desiccation, mild loss of disc height, and a mild disc bulge without spinal canal stenosis. Minimal narrowing of the right L3-L4 and L4-L5 neural foramina is also noted without clear evidence of impingement.
No significant change in size or appearance of the right paraspinal masses at T12, L1-L2, and L3 levels. Again seen is the L1-L2 mass extending to fill the right L1-L2 neural foramen, where there may be impingement of the right L1 nerve root. The extra foraminal right L2 and right L3 nerve roots are also noted to contact the above mentioned masses.Rightward displacement of the conus which may be related to an adjacent arachnoid cyst or adhesions. Finding is unchanged since at least 12/28/2010.