• L3-S1 posterior decompression and fusion. There is recurrent spinal canal stenosis at the upper adjacent segments at L2/L3 and L3/L4.
• Advanced degenerative changes were present at the L1-L2 disc level. Type I endplate marrow reaction is noted together with a posterior annular fissure and minor bulge. There is no significant central canal stenosis at any level and the distal thoracic cord and conus appear intact. There is also no obvious foraminal nerve root compression demonstrated. No other marrow lesion is identified and no abnormality is seen in the pre-sacral space or the imaged portion of the sacrum. No obvious complication is seen in relation to the previous surgery, although the left L5 pedicle screw does penetrate the anterior cortex of the sacrum and abuts the adjacent iliac vessels.