Reason: coagulopathic, s/p LESI 12/8 while on coumadin, new symptoms of LB pain/weakness -- R/O bleed History: new c/o of perineal pain, worsening R>L LBP Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are normal. There is levoscoliosis of the lumbar spine with apex at the L2-L3 level. Alignment is otherwise maintained. Conus is in normal position. Bone marrow signal is benign. No evidence of hematoma in the spinal canal. There are multilevel degenerative changes which are again seen, individual levels as below:T12-1: No significant spinal canal or neural foraminal stenosis.L1-L2: Tiny left foraminal/extraforaminal disc protrusion similar to prior. There is minimal narrowing of the left neural foramen and contact of the left L1 nerve root. Otherwise no significant spinal canal or neural foraminal stenosis.L2-3: There is disc bulge, similar to prior, and moderate bilateral facet arthropathy. There is decrease in facet effusions. There is mild right neural foraminal stenosis similar to prior. No significant central canal or left neural foraminal stenosis.L3-4: Mild disc bulge similar to prior, ligamentum flavum thickening, and moderate bilateral facet arthropathy. There is decrease in facet effusions. There is mild bilateral neural foraminal stenosis. Minimal associated central canal narrowing. L4-5: Moderate bilateral facet arthropathy. No significant spinal canal or neuroforaminal stenosis. Again seen is evidence of a prior left-sided laminectomy.L5-S1: No significant spinal canal or neural foraminal stenosis. Small right posterior annular fissure again seen. Mild bilateral facet arthropathy.
1. No evidence of hematoma in the spinal canal. No significant spinal canal stenosis in the lumbar spine, aside from minimal central canal narrowing at L3-L4 and to an event lesser degree at L2-L3.2. Degenerative changes, which primarily involve multilevel facet arthropathy and relatively worse at the L2-L3 and L3-L4 levels. There is mild bilateral L3-L4 and right L2-L3 neural foraminal stenosis. No high-grade neural foraminal stenosis. There is levoscoliosis of the lumbar spine with apex at the L2-L3 level. Please see details above.