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The L1-L2 intervertebral disc shows minimal desiccation and tiny broadbased bulge with no associated canal or foraminal stenosis. The L2-L3 and L3-L4 interverbral disc show no significant abnormality.
The L4-L5 disc shows desiccation and height loss. Low T1 and low T2 signal along the right paramidline region of this disc and more prominently within the right subarticular region shows mild enhancement after contrast administration that is compatible with granulation tissue rather than recurrent disc pathology. This granulation tissue is contiguous with granulation tissue seen within the right L4 laminectomy site. This process causes narrowing of the inferior right L4-L5 neural foramen and abuts posterior aspect of the proximal L5 nerve root on the right.
The L5-S1 disc showed no significant abnormality.
IMPRESSION:
1) Postsurgical changes of right L4 laminectomy.
2) Granulation tissue extending from the laminectomy site extends into the subarticular region on the right at L4-L5 and causes neuroforaminal narrowing at this level and abuts the posterior aspect of the right L5 nerve root. This granulation tissue also abuts the right posterolateral aspect of the thecal sac but does not deform the sac.
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