Female, 65 years old, status post L3 paraspinal tumor resection. Postoperative findings are seen compatible with resection of a tumor from the left paraspinal region at L3. The resection includes laminectomy at L3, partial laminectomy at L2 and L4, resection of the left L3 transverse process, resection of the L3 facet and part of the L2 and L4 facets, resection of the L3 pedicle and a portion of the L3 vertebral body. Most or all of the previously seen intensely enhancing tumor has been removed. A fingerlike area of mild enhancement projecting along the left edge of the vertebral body (image 19 series 12) was present on the preoperative exam, but it is unclear if this tissue was part of the tumor. Mild enhancement elsewhere in the operative bed is nonspecific.No new enhancing lesions are seen. Marrow signal characteristics remain heterogeneous similar to prior. A mild dextroscoliosis is unchanged. Trace retrolisthesis of L3 relative to L4 is demonstrated. Surgical instruments are in place fusing L2-L4.L1-2: Minimal degenerative disease. No significant spinal canal or foraminal stenosis. L2-3: Mild degenerative disease. No significant spinal canal stenosis. The left neural foramen is obscured by operative changes. L3-4: Facet arthropathy and ligamentum flavum thickening. Disc bulging. Mild spinal canal stenosis. The left neural foramen is obscured by postoperative changes. The right neural foramen remains moderately narrowed. L4-5: Facet arthropathy. Ligamentum flavum thickening. Minimal disc bulging. No spinal canal stenosis. Severe right and moderate left foraminal narrowing. L5-S1: Facet arthropathy. Ligamentum flavum thickening. Minimal disc bulge. No spinal canal stenosis. Mild foraminal narrowing.
Postoperative findings are seen compatible with resection of a tumor from the paraspinal region at L3. It appears that most or all of the previously demonstrated intensely enhancing tumor has been resected. There is mild nonspecific enhancement in the operative region, including a fingerlike area of enhancement which projects along the left edge of the vertebral body. Attention to these areas will be required on subsequent exams.