What is the salient finding?
Small dural defect resulting in a large paraspinal pseudomeningocele.
Can the patient's radicular symptoms be explained by looking at these images?
Yes. A few entrapped cauda equina nerve fibres are present within the cystic CSF collection.
Evidence of previous laminectomy at L3 and L4.
Large irregular fluid collection at the level of previous surgery, following CSF signal intensity on all sequences, demonstrating a thin rim of enhancement after contrast administration with enhancing perilesional postoperative changes. It appears to be communicating with the thecal sac via a tiny defect in the dorsal dural coverings opposite L3, through which a few cauda equina nerve fibres are herniating.
Small homogenously enhancing filum terminale mass at the level of L4, consistent with the patient's known residual intradural tumour. A fatty filum terminale is incidentally noted.
Normal conus termination.
Degenerative disc bulge with a small central annular fissure at L5/S1.