49 years Male (DOB:7/31/1967)Reason: evaluate for left lumbar root impingement or left lumbosacral plexus injury/inflammation History: hx of L3-L4 disc placement, chronic back pain, left thigh pain and numbness after surgery 4/15/2016 which was done via anterior approachReferring Attending: SERVICES ANCILLARY Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. No abnormal enhancing lesions are appreciated in the lumbar spine.Since the prior exam patient is undergone lumbar spine surgery anteriorly at the L3-4. There is metallic artifact which obscures the L3-4 level.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a disc bulge present at this level. There is some facet hypertrophy. Since the prior exam the disc bulge at L5-S1 appears to have extended a little further and now mildly abuts the nerve roots at the lateral recesses.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is a mild disc bulge present this level.At L3-4 there is no significant compromise to spinal canal or neural foramina identified, however, this level is partially obscured by metal artifact..At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
The patient status post lumbar spine surgery at the disc space of L3-4. The L3-4 level is obscured by metal artifact. To the extent of visualization there is not appear to be significant compromise to spinal canal at this level.There are degenerative changes present in the lumbar spine worse at L4-5 and L5-S1 where there are disc bulges present without significant compromise to the spinal canal or exiting nerve roots. Since the prior exam a disc bulge at L5-S1 appears to have extended further into now abuts the nerve roots at the lateral recess bilaterally..