[rbrown]

MRI Lumbar Spine without and with Gadolinium 3/30/2011:Clinical Indication: Chronic low back pain and bilateral radiculopathy; history of surgery 2006.
Findings:
There is evidenc of a prior right hemilaminotomy at L4. There is no evidence of epidural fibrosis.
The L3-L4, L4-L5 and L5-S1 intervertebral discs have diminished height and signal intensity.
There is a grade 1 anterior spondylolistheses of L5/S1 which appears to be secondary to bilateral spondylolysis. Bulging of the L5/S1 disc is present. There is no secondary spinal stenosis or impingement on the S1 nerves. The alignment abnormality is producing bilateral L5 interbertebral foraminal excroachment with possible mild impingement on the left and right L5 nerves.
Minimal disc bulges are present at L3-L4 and L4-L5 without significant excroachment on the spinal canal.
The remaining disc levels are normal. The facet joints and intervertebral foramen are normal.
The distal spinal cord and conus medullaris are normal. No intradural, vertebral marrow space or paraspinal signal abnormalities are present.
No abnormal enhancement is present on the postcontrast injection images.
Impression:
Status post right L4 hemilaminotomy.
Grade 1 anterior spondylolistheses at L5-S1 which is producing bilateral L5 intervertebral foraminal encroachment and possible left and right L5 nerve impingement. There is no central spinal stenosis or S1 nerve impingement.
Bulging discs at L3-L4 and L4-L5.
Otherwise normal MR examination of the lumbar spine.