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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can You Explain What All This Means? History: 48 Yo

Can you explain what all this means?

History: 48 yo m with history of laminectomy at L3-L4.
1.5 years S/P surgery, hefell in Qatar and injured his
back. He is getting the work done as Workman
compthrough DynCorp International. Please evaluate.
thank you. Comparison: 7/29/2013 Technique:
Multiplane /multisequence MR images of the lumbar
spine submitted forthis protocol. 16 cc of Magnevist per
protocol. Findings: Osseous as well as cord signal
intensity appear unremarkable. Cordterminates at the
L1 junction. Visualized paraspinal musculature
demonstrate noabnormal signal intensity. The
visualized kidneys demonstrates nohydronephrosis.
Incidental note made of a left retroaortic renal vein. L1L2,
L2-L3:
Mild
facet
disease
with
associated
mild

biforaminal
narrowing.
L3-L4:
Postoperative
changes
at

the
L3-L4
level
without
signs
of
complication.Broad
disc

bulge without significant canal stenosis. Additionally
there is facetdisease with associated moderate left
greater than right biforaminal narrowing.There is
encroachment upon the left L3 nerve by disc material.
There is alsothe appearance of mild diffuse congenital
short pedicles. There is mild diffusesoft tissue
enhancement throughout the surgical bed, possibly
developinggranulation tissue. No focal fluid collection to
suggest abscess formation. L4-L5: Broad disc bulge
effacing ventral thecal sac resulting in mild centralcanal
narrowing. Facet disease and ligamentum flavum
hypertrophy resulting inmoderate left greater than right
biforaminal narrowing. There is encroachmentupon the
left L4 nerve root by disc material. L5-S1: Broad disc
bulge with associated annular fissure without
centralnarrowing. Facet disease and ligamentum
flavum hypertrophy resulting in severebiforaminal
narrowing. IMPRESSION: 1. Postoperative changes at
the L3-L4 level without signs of complication. 2.
Multilevel degenerative most notable at the L4-L5 level
with broad bulgedisc resulting in mild central canal
narrowing. Additionally facet disease andligamentum
flavum hypertrophy resulting in moderate left greater
than rightbiforaminal narrowing. There is encroachment
upon the left L4 nerve root by discmaterial. 3. Broad
disc bulge, annular fissure and severe biforaminal
narrowing at theL5-S1 level.
Sat, 15 Aug 2015
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Can You Explain What All This Means? History: 48 Yo