Male, 71 years old, with right leg weakness, pain, status post minimally invasive procedure with blood products. Postoperative findings are seen compatible with laminotomy and facetectomy on the left at L3-4 and L4-5. Fluid which was seen previously in the operative bed has resolved and has been replaced by hypointense tissue perhaps representing scarring. There is no longer any mass effect upon the underlying thecal sac.The vertebral bodies are otherwise intact and demonstrate normal height. Alignment is within normal limits. Scattered Schmorl's node deformities and degenerative endplate signal abnormality is redemonstrated similar to the prior examination. The visualized distal spinal cord and conus are within normal limits.L1-2: Mild facet arthropathy and ligamentum flavum thickening. Minimal disc bulging. No significant spinal canal or foraminal stenosis. No interval changes. L2-3: Facet arthropathy and ligamentum flavum thickening. A 4-mm cystic structure has newly developed along the right ligamentum flavum. This lesion projects into the spinal canal, displacing several adjacent nerve roots. Disc bulging is seen. Findings contribute to produce a mild spinal canal stenosis, and mild right foraminal narrowing. Except as above, no other interval changes are seen. L3-4: Postoperative findings. Resolution of prior fluid in the operative bed and reexpansion of the thecal sac. Advanced facet arthropathy. Disc bulging. Mild spinal canal stenosis, improved from prior. Mild bilateral foraminal narrowing, similar to prior. L4-5: Postoperative findings. Resolution of prior fluid in the operative bed and reexpansion of the thecal sac. Advanced facet arthropathy. Disc bulging. No significant spinal canal stenosis, improved from prior. Moderate bilateral foraminal narrowing, unchanged. L5-S1: Advanced facet arthropathy. Ligamentum flavum thickening. Bulging disc with a superimposed right paracentral extrusion which may contact the descending S1 nerve root. The spinal canal is narrowed similar to prior. Moderate to severe left and moderate right foraminal narrowing, unchanged.
1.Postoperative findings are seen compatible with laminotomy and facetectomy on the left at L3-4 and L4-5. Fluid which was seen previously in the operative bed has resolved. Associated mass effect on the adjacent thecal sac has also resolved.2.A new 4 mm cyst of the right ligamentum flavum has developed at L2-3 resulting in displacement of several of the adjacent nerve roots.3.Disc bulging with a right paracentral extrusion is redemonstrated at L5-S1 without significant interval change. As before, this lesion may impinge upon the descending right S1 nerve root.4.Degenerative findings at the other levels are not significantly changed.