61-year-old woman status post laminectomy and discectomy 12/1/2016, now with left lower extremity weakness. Five lumbar type vertebral bodies are presumed to be present with hypoplastic ribs at L1. Vertebral body heights are within normal limits. There is minimal retrolisthesis of L5 on S1, otherwise alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position at L1/L2.The patient is status post L5 laminectomy. There is increased T2 signal material in the midline paraspinal musculature with low T1 signal. No discrete fluid collections are identified. Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: There is a disc bulge without spinal canal or neural foraminal stenosis.L3-L4: There is a disc bulge and left facet arthropathy. There is mild bilateral neural foraminal narrowing but no spinal canal stenosis.L4-L5: There is a disc bulge. The spinal canal is distorted by the dorsal increased T2 signal tissue (801/6) resulting in moderate to severe central stenosis. There is mild bilateral neural foraminal narrowing.L5-S1: There is a disc bulge and facet arthropathy, left greater than right. The dorsally increased T2 signal tissue extends to this level, more asymmetrically prominent to the right, with moderate spinal canal stenosis. There is moderate left and mild right bilateral neural foraminal narrowing.
1.Postoperative findings with T2 hyperintense signal in the laminectomy bed causing distortion of the spinal canal from L4 to S1. This signal may represent a combination of edema and granulation tissue, but there is no discrete fluid collection in this location. Overall, there is resultant moderate to severe central stenosis at L4-L5 and moderate central stenosis at L5-S1.2.Additional multilevel degenerative change with mild and moderate neural foraminal stenoses.