Recurrent symptoms after microdiscectomy. There is sacralization of the L5 vertebra. There are postoperative findings related to microdiscectomy at L3-4, with patchy enhancement in the soft tissues along the surgical approach. There is a central disc extrusion with superior migration that measures up to 9 mm in width and 17 mm in length superimposed upon a disc bulge at L3-4, which results in severe spinal canal narrowing. In conjunction with bilateral facet hypertrophy at this level, the bilateral neural foramina are at least moderately narrowed. There is a disc bulge and bilateral facet hypertrophy at L4-L5 with mild bilateral lateral recess narrowing and mild left and moderate right neural foraminal narrowing. There is mild degenerative spondylosis at L1-2 and L2-3, without significant spinal canal or neural foraminal stenosis. Aside from mild degenerative signal alterations, the vertebral bone marrow signal is unremarkable. There are multilevel small intravertebral disc herniations, but the vertebral body heights are essentially preserved otherwise. The spinal cord displays normal signal and morphology. There is a large right renal cyst.
1. Postoperative findings related to microdiscectomy at L3-4, with a central disc extrusion superimposed upon a disc bulge at this level and resultant severe spinal canal narrowing. In conjunction with bilateral facet hypertrophy at this level, the bilateral neural foramina are at least moderately narrowed.2. A disc bulge and bilateral facet hypertrophy at L4-L5 result in mild bilateral lateral recess narrowing and mild left and moderate right neural foraminal narrowing.