Feeling miserable, pain meds provide minimal relief

Any ideas?

FINDINGS: This report assumes 5 non-rib bearing lumbar type vertebral bodies. (Correlation with radiographs of the lumbar spine is recommended to better assess numbering of lumbar vertebral bodies, particularly if a surgical intervention is being considered for the patient).

Alignment: Grade 2 anterolisthesis of L5 on S1.
Bone: Vertebral body heights are preserved. Posterior instrumented fusion at L5-S1 with pedicle screws and vertical rods. Additional laminectomy of L5-S1.

Nerves: Conus medullaris is normal in position terminating at L1

Muscles: Symmetric bulk.

Soft Tissues: Unremarkable.

At T12-L1, no spinal canal or neuroforaminal narrowing

At L1-L2, no spinal canal or neuroforaminal narrowing

At L2-L3, no spinal canal or neuroforaminal narrowing

At L3-L4, no spinal canal or neuroforaminal narrowing

At L4-L5, facet joint hypertrophy. No spinal canal narrowing. Mild bilateral neuroforaminal narrowing

At L5-S1, grade 2 anterolisthesis. Disc uncovering. Disc bulge. Spinal canal is decompressed by laminectomy. Facet arthrosis. Moderate bilateral neuroforaminal narrowing. Evaluation degraded by susceptibility artifact from hardware.

Abdomen/Retroperitoneum: Multiple cysts are noted in both kidneys.

Fusion hardware is noted across the right SI joint. Joint space narrowing of bilateral SI joints.

IMPRESSION:

1. Posterior instrumented fusion and laminectomy at L5-S1. Grade 2 anterolisthesis L5-S1. Facet arthrosis with moderate bilateral neuroforaminal narrowing at this level. No change since prior exam.

2. Facet joint hypertrophy at L4-L5 with mild bilateral neuroforaminal narrowing.