Male, 56 years old, status post L5-S1 fusion. Assess for proximal nerve root compression as a source of left hip and lower extremity pain. Posterior and interbody instrumented fusion has been performed at L5-S1. A laminectomy defect is also evident on the left at this level. Assessment of the surgical instruments is better made on the accompanying CT examination.Apart from surgical changes at L5-S1, vertebral body height and morphology are within normal limits. No evidence of pathologic marrow replacement is seen. The visualized distal spinal cord, conus and nerve roots of the cauda equina are within normal limits. No epidural abnormalities are suspected.L1-2: Minimal facet arthropathy. No spinal canal or foraminal compromise. L2-3: Mild facet arthropathy. Mild bulging disc with central annular fissuring. No significant spinal canal compromise. Mild bilateral foraminal narrowing. No interval changes. L3-4: Facet arthropathy. Bulging disc with a small central protrusion. No significant spinal canal compromise. Moderate bilateral foraminal narrowing. No interval changes. L4-5: Facet arthropathy. Disc bulging with a central/right paracentral protrusion. No significant spinal canal compromise. Moderate bilateral foraminal narrowing. No interval changes. L5-S1: Facet arthropathy. Disc degeneration with postoperative changes. The fat of the left lateral recess is effaced by T1 and T2 hypointense material which could represent a disc osteophyte complex or perhaps scarring from surgical intervention (see image 19 series 801). This finding contributes to moderate left foraminal narrowing, similar to that seen on prior. The right neural foramen is mildly narrowed. No significant general spinal canal compromise.
1.Postoperative findings are seen compatible with instrumented fusion from L5 to S1.2.At the L5-S1 level, the left lateral recess and left neural foramen are narrowed by T1/T2 hypointense material which could represent disc osteophyte formation or postoperative scarring. No significant generalized spinal canal compromise is seen at this or any other level.3.Relatively mild degenerative findings are seen at the other lumbar levels without significant interval change.