Pain. Evaluate for stenosis Five lumbar type vertebral bodies are present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. There are postsurgical changes of posterior spinal fusion at L4-L5. Hardware appears well-positioned. There appears to be solid fusion involving the posterior elements at the L4-L5 levels, better seen on CT.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: Minimal disc bulge eccentric to the right. Minimal right neural foraminal narrowing. No significant spinal canal or left neural foraminal stenosis. There is facet arthropathy with vacuum phenomena bilaterally.L4-L5: Minimal disc bulge and right foraminal osteophyte. Otherwise no significant disc disease. Minimal right neural foraminal narrowing. No spinal canal or left neural foraminal stenosis.L5-S1: No significant disc disease. No spinal canal stenosis. There is mild bilateral neural foraminal stenosis. Advanced bilateral facet arthropathy with vacuum phenomena.Paraspinous soft tissues demonstrate postsurgical changes but are otherwise unremarkable.
Postsurgical changes of L4-L5 fusion. No significant spinal stenosis at any level. Mild neural foraminal narrowing as described above. There is advanced bilateral facet arthropathy at L5-S1 which may be contributing to patient's low back pain.