58 year old female with back pain and history of lumbar fusion, evaluate for reherniation. Vertebral body heights are intact. Straightening of the normal lumbar lordosis is unchanged. Focus of increased T2 signal within the S1 vertebral body is unchanged and likely represents focal fat or a hemangioma. There has been interval spinal fusion of L5-S1 with posterior stabilization rods and pedicle screws entering the pedicles of L5 and S1 in near-anatomic alignment. Disk desiccation of L3-L4 and L4-L5 is unchanged. Signal within the distal cord and cauda equina is unremarkable with the conus terminating at L1-L2. Mild clumping of the cauda equina nerve roots at L4-5. No paraspinous fluid collections.T12-L1: No spinal canal or neuroforaminal stenosis.L1-L2: No spinal canal or neuroforaminal stenosis.L2-L3: No spinal canal or neuroforaminal stenosis.L3-L4: Mild diffuse disk bulge and ligamentum flavum hypertrophy, unchanged. Mild facet joint arthropathy. Minimal central canal and mild right neuroforaminal stenosis, unchanged.L4-L5: Mild diffuse disk bulge, asymmetric to the right, with ligamentum flavum hypertrophy, unchanged. Mild facet arthropathy. No significant spinal canal or neural neuroforaminal stenosis. L5-S1: Interval L5-S1 fusion without evidence of reherniation. There is a spacer device within the L5-S1 disk space. Susceptibility artifact limits evaluation, however no spinal canal stenosis or high grade neural foraminal stenosis is seen.
Interval L5-S1 fusion without evidence of recurrent disc herniation. Mild clumping of the cauda equina nerve roots is seen at the L4-5 level which may suggest arachnoiditis. Individual levels as detailed above.