Right sciatic pain s/p L4-5 transforaminal lumbar interbody fusion and facetectomy and laminotomy for lumbar radiculopathy and synovial cyst on 7/7/15. There are interval postoperative findings related to posterior spinal fusion at L4 and L5 level with intervertebral spacer, with decreased right spinal canal stenosis, but persistent left lateral recess narrowing at this level. There is confluent low T1 and T2 signal material along the right surgical approach, extending into the right lateral recess and medial aspect of the neural foramen at L4-5. This tissue appears to impinge upon the exiting nerve roots. The more lateral aspect of the right neural foramen appears wider than before. Likewise, there is decreased left L4-5 neural foraminal narrowing. Bilateral L3-4 and L5-S1 neural foraminal and L5-S1 spinal canal stenoses are not significantly changed. Furthermore, mild degenerative spondylosis at L1 through L3 is unchanged. The alignment is unchanged. The vertebral body heights are maintained. The conus is normal in signal and morphology and terminates at an appropriate level. There is fatty atrophy of the paraspinal muscles.
Interval postoperative findings related to posterior spinal fusion at L4 and L5 level with intervertebral spacer, with decreased right spinal canal stenosis, but persistent left lateral recess narrowing at this level. Confluent low T1 and T2 signal material along the right surgical approach, extending into the right lateral recess and medial aspect of the neural foramen at L4-5 may represent scar tissue, but is incompletely characterized without contrast. Nevertheless, this tissue appears to impinge upon the exiting nerve roots. Otherwise, the more lateral aspect of the right neural foramen appears wider than before. Likewise, there is decreased left L4-5 neural foraminal narrowing. Bilateral L3-4 and L5-S1 neural foraminal and L5-S1 spinal canal stenoses are not significantly changed. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.