Clinical question: Evaluate cause of pain. Signs and symptoms: Right leg and back pain. Nonenhanced lumbar MRI:The lower most visualized thoracic spine and thoracic cord demonstrate mild degenerative change is an unremarkable otherwise.T12-L1, L1-L2 and L2-L3 levels are unremarkable with the exception of mild hypertrophic changes of posterior elements.L3-L4 demonstrate mild disc disease and moderate bilateral ligamentum flavum hypertrophy and mild facet degenerative changes. There is mild mass effect on the posterolateral aspect of thecal sac secondary to hypertrophied ligamentum flavum however no central spinal stenosis or neural foraminal compromise is present.L4-L5 demonstrate a stable postoperative changes of posterior fusion and placement of transpedicular screws in L4 and L5 levels. Trace anterolisthesis similar to prior study is again noted. No definitive evidence of neural foraminal compromise.L5-S1 demonstrate moderate disc disease and loss of disc height, expected postoperative changes of posterior fusion, no central spinal stenosis. Precise assessment of neural foraminal at this level is not possible due to extensive metallic hardware artifact from fusion. On axial images poorly visualized neural foramina at this level however demonstrate no convincing evidence of stenosis.
1.No convincing evidence of any acute or new findings since prior study.2.Stable post operative changes of posterior fusion at L4-L5 and with placement of bilateral transpedicular screws at L4 and L5 levels.3.No spinal stenosis or neural foraminal compromise at any level.