 Images are somewhat limited by patient motion. The lumbar spine is in normal alignment, with straightening of the normal lumbar lordosis. The vertebral body and disk heights are stable, with mild-moderate disc narrowing at L4-L5 and moderate disc narrowing at L5-S1. Mild disc narrowing is present at L1-L2. Disc desiccation is again present from L3-L4 through L5-S1, and to a lesser degree at L1-L2. No worrisome focal marrow signal abnormality is appreciated, with redemonstration of severe endplate degenerative changes at L4-L5. The distal spinal cord and conus are within normal limits with the conus terminating at the mid L2 level. There is developmental narrowing of the lumbar spinal canal due to shortened pedicles and prominence of dorsal epidural fat.At T12-L1, there is persistent bilateral facet arthropathy and ligamentum flavum thickening.At L1-L2, there is persistent bilateral facet arthropathy and ligamentum flavum thickening.At L2-L3, there is prominent bilateral facet arthropathy and ligamentum flavum thickening. There is mild developmental narrowing of the central spinal canal.At L3-L4, there appears to be slight decreased crowding of the cauda equina nerve roots within the thecal sac. There is bilateral facet arthropathy and ligamentum flavum thickening with overall mild-moderate central spinal canal stenosis.At L4-L5, there has been interval complete resolution of previously seen left paracentral disc protrusion. There is a residual mild disc bulge. Postoperative changes are again seen from remote right-sided laminotomy. The left lateral recess is now patent. There is mild-moderate developmental central spinal canal stenosis remaining at this level, with improved visualization of the CSF within the thecal sac. There is stable mild right foraminal narrowing. There remains right greater than left facet arthropathy as well as left ligamentum flavum thickening.At L5-S1, there is a stable shallow central/left paracentral disc protrusion which abuts the descending left S1 nerve root. There is moderate bilateral facet arthropathy and left ligamentum flavum thickening. There is again slight encroachment upon the left lateral recess. There is mild left foraminal narrowing. Right-sided postoperative changes from previous laminotomy are again noted.
1.Interval resolution of previously seen left paracentral disc protrusion at L4-L5 with decreased mass effect upon the thecal sac, as there is only a mild residual disc bulge with mild-moderate developmental central spinal canal stenosis at this level. Also associated decreased crowding of cauda equina nerve roots at L3-L4.2.Stable minimal central/left paracentral disc protrusion at L5-S1 which continues to abut the descending left S1 nerve root. 