 Redemonstrated are post-surgical changes related to posterior spinal fusion with bipedicle screws at L3 and L4 as well as intervertebral disc spacer. There straightening of the usual lumbar lordosis. The vertebral body heights are preserved. The vertebral bone marrow signal is mildly heterogeneous. The spinal cord displays normal signal and morphology. However, there is mild enhancement of the cauda equina nerve roots. The tip of the conus medullaris terminates at the level of L1. There is lumbosacral epidural lipomatosis. There is a 2.5 cm cyst in the lower pole of the right kidney with fluid-fluid level, likely representing a hemorrhagic cyst. There is also a 1.4 cm right renal cystic lesion. There is diffuse paraspinal muscle atrophy.T12-L1: No significant disc bulge, spinal canal or foraminal stenosis. L1-L2: Mild bilateral facet arthropathy. No significant disc bulge, spinal canal or foraminal stenosis.L2-L3: Disc bulge and bilateral facet arthropathy, contributing to mild left greater than right foraminal stenosis. No significant spinal canal stenosis.  L3-L4: Status post laminectomies at L3 and L4. Evaluation is somewhat limited by susceptibility artifact, but no significant spinal canal or foraminal stenosis. L4-L5: Mild disc bulge and bilateral facet arthropathy, contributing to mild bilateral foraminal stenosis. No significant spinal canal stenosis. L5-S1: Mild disc bulge and bilateral facet arthropathy. No significant spinal canal or foraminal stenosis.
1. Post-surgical changes related to posterior spinal fusion and intervertebral disc spacer at L3-L4. 2. Lumbosacral epidural lipomatosis and degenerative lumbar spondylosis with mild foraminal stenosis at L2-L3 and L4-L5, without significant spinal canal stenosis. Evaluation at L3-L4 is somewhat limited by susceptibility artifact.3. Apparent mild enhancement of the cauda equina nerve roots without associated thickening, which may be infectious or inflammatory in etiology. 4. Bilateral renal cystic lesions. Renal ultrasonography may be useful for further characterization. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.