Male, 14 years old, history of pars fracture with fusion, hardware complications status post removal, status post fall. Assess for disc herniation or other abnormality. Patient presenting with stabbing back pain and shooting right leg pain. Since the prior examination, the interconnecting rods and the pedicle screws at L5 have been removed. Pedicle screw fragments remain in place bilaterally at S1.Apart from the screw tracks, no abnormal marrow signal intensity is seen. Evidence of bilateral pars defects is redemonstrated at L5. The osseous structures otherwise appear intact. Vertebral body heights are preserved.Endplate irregularity and a Schmorl's node deformity are evident at the inferior T11 endplate. This irregularity is better appreciated on same day radiographs.A grade 1 anterolisthesis of L5 relative to S1 appears slightly more pronounced than on the prior MRI. Spinal alignment is otherwise unremarkable.The visualized spinal cord, conus and nerve roots of the cauda equina are within normal limits. No epidural collections are suspected.Mild disc uncovering is seen at L5-S1. No significant disc herniations are demonstrated. No spinal canal or neuroforaminal stenosis is suspected.
1.Evidence of surgical revision with removal of the posterior interconnecting rods and pedicle screws at L5. Pedicle screw fragments remain at S1.2.No evidence of marrow edema or other significant marrow signal abnormality. L5 pars defects are again seen. A grade 1 anterolisthesis of L5 relative to S1 is slightly more pronounced than on the prior MRI.3.No spinal canal or neuroforaminal stenosis.4.Incidental note is made of endplate irregularity and a Schmorl's node along the inferior endplate of T11. These findings are only partially visualized on this examination but are better appreciated on the same day radiographs. If pain localizes to this area or if there is concern for a thoracic spine abnormality, further evaluation with dedicated thoracic MRI can be considered.