Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a left - sided pacemaker with two leads terminating in appropriate position at the right atrium and ventricle . The lungs are clear without focal consolidation , pleural effusion or pneumothorax . The heart size is top normal . Degenerative changes are noted in the thoracic spine , and lumbar posterior fusion hardware is partially visualized .
    OUTPUT:
    
Pacemaker with leads in appropriate position . Posterior lumbar fusion hardware .