Dear Dr. Corenman,
Thank you for your explanation.
I have done New MRI last week. kindly have me your thoughts about it.
Post-lumbar decompression 5 months back, now complains of weakness in right lower limb.
multiplanar multiecho imaging of lumbosacral spine is carried out with and without contrast according to departmental protocol.
No previous imaging is available comparison.
There is evidence of right laminectomy at L4 and L5 levels consistent with previous history of decopressive surgery.
There is normal alignment and durvature of lumbosacal spine.
Vertebral body heights and signals are well preserved.
Disk dehydration is identified at L4-L5 and L5-S1 levels.
Diffuse posterior disk bulge is noted at L5-S1 level compressing the thecal sac and resulting in mild right lateral recess narrowing.
Mild posterior disk bulge is noted at L4-L5 level causing indentation on thecal sac, however, no neural foraminal compromise or radicular compression seen at this level.
Mild abnormal signals are identified in L4—L5 and L5-S1 disks posteriorly with enhancement on post-contrast imaging raising the possibility of focal discities.
Enhancing granulation tissue is identified at laminectomy site extending into posterior spinal soft tissues.
There is minimal intraspinal extension of this granulation tissue at lower L5 level without any significant thecal sac compression. No intraspinal fluid collection or abscess formation is seen.
The rest of the disks show no significant protrusion or herniation.
Conus medullaris terminates at its normal position.
Status post partial laminectomy at L4 and L5 levels with postsurgical changes. Mild diffuse posterior disk bulges are noted at L4-L5 and L5-S1 levels with mild right lateral recess narrowing at L5-S1 level. No radicular compression seen on either side at these two levels.
Focal abnormal signal with post-contrast enhancements identified involving L4-L5 and L5-S1 disks posteriorly rasing the possibility of focal discitis.
Clinical correlation and follow-up are recommended.