 Exam is limited due to lack of contrast.The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. The imaged spinal cord displays normal signal and morphology with the conus terminating at L1. The paravertebral soft tissues are unremarkable.L1-L2: Unremarkable.L2-L3: Unremarkable.L3-L4: Unchanged mild disc desiccation and minimal disc bulge with a small posterior probable annular fissure without spinal canal or neural foramen stenosis.L4-L5: There are postoperative findings related to prior laminectomy and discectomy. There is disc desiccation and disc bulge with a moderate superimposed central/left paracentral contiguous material that is mildly decreased in size compared with the prior exam. There is also moderate bilateral facet arthropathy and left sided ligamentum flavum thickening that has progressed since the prior exam. These findings result in moderate spinal canal stenosis that is nonetheless improved compared with the prior exam as well as mild bilateral neural foramen narrowing. There remains bunching of the cauda equina nerve roots.L5-S1: Mild disc desiccation but otherwise unremarkable.
Disc bulge at L4-L5 with a superimposed prominence of tissue along the central/left paracentral location, which could represent residual or recurrent disk versus granulation tissue, as exam is limited due to lack of contrast in this postoperative patient. That in combination with facet arthropathy results in moderate residual spinal canal stenosis that is nonetheless improved compared with the prior exam. A contrast exam is suggested to distinguish between these entities.