Postlaminectomy syndrome, not elsewhere classified [M96.1], Reason for Study: ^Reason: back pain s/p back surgery in 2008 History: back pain Thoracic spine MRIThere are subtle T2 high signal intensity lesions at the level of the T23 and T34 spinal cord gray matter which are not conspicuous on sagittal scan and only shows one level. Thus, these lesions are most likely artifactual.Otherwise, there is normal thoracic kyphosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. Incidental finding of T2 high and T1 iso or low signal intensity well circumscribed lesions seen on the right side of distal trachea and somewhat anterior aspect of the aortic arch level mediastinum. These lesions may indicate prominent mediastinal fat, however, if clinically indicated, chest CT can be considered for further imaging evaluation.L-spine MRIThere is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The conus medullaris terminates at the L1-2 level. The paraspinal soft tissues are unremarkable.Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: no neuroforaminal narrowing or spinal stenosis. L2-L3: diffuse bulging of disc, no significant neuroforaminal narrowing or spinal stenosis. Bilateral facet hypertrophies.L3-L4: Diffuse bulging of disc is with bilateral ligamentum flavum thickening result in mild to moderate spinal canal stenosis. L4-L5: Diffuse bulging of disc is with bilateral ligamentum flavum thickening result in mild to moderate spinal canal stenosis. L5-S1: There is Modic2 changes of endplates. There is T1 low and T2 low signal intensity lesion connected with L5S1 disc protruded into the anterior epidural space which abuts thecal sac. This lesion may represent disc herniation but could also represent postoperative fibrosis. If clinically indicated, Gad enhanced MRI can be considered. There is evidence of bilateral laminectomy at this level.
1. No evidence of spinal canal stenosis or abnormal spinal cord signal at the level of thoracic spine.2. Multilevel various degree spinal stenosis at lumbar spine including L34 and L45.3. Disc space degeneration with possible disc protrusion at the level of L5S1 with evidence of bilateral laminectomy.4. Upper mediastinal well circumscribed mass lesion which may represent mediastinal fat/lipoma. If clinically indicated, chest CT scan can be considered.