 Postoperative changes are again seen at the L4-S1 levels from previous anterior surgical fusion. The spine is in normal alignment. The vertebral body and disk heights are grossly stable, with mild disc narrowing and desiccation along the lower thoracic spine and cervical spine. However, susceptibility artifact from indwelling hardware limits evaluation of the L4 to S1 vertebra. Prominent endplate degenerative changes are noted at C6-C7. Stable STIR hyperintensity is noted along the superior endplate of L4 extending into the pedicles, as well as involving the L5 pedicles bilaterally. There is also mild stable STIR hyperintensity in the S1 vertebra. The spinal cord is grossly of normal caliber and signal. There is no MR evidence of cord compression. There is suggestion of perhaps moderate central spinal canal stenosis at C5-C6 due to a diffuse posterior osteophyte disc complex, which appears somewhat progressed since previous February 2015 counting image from MRI of the thoracic spine. Prominent ligamentum flavum thickening is noted at T2-T3 and T3-T4.Prevertebral STIR hyperintense collections are noted at the L4-L5 and L5-S1 levels, to be further detailed on the separately dictated dedicated MRI of the lumbar spine. The collection along the mid L4 to L4-L5 level measures 1.7 cm CC x 0.7 cm AP. Collection spanning the L5 level measures 3.6 cm CC x 0.8 cm AP. There is mild adjacent stranding within the fat. There is moderate encroachment upon the L5-S1 foramina bilaterally due to nonspecific soft tissue along the posterior aspect of the interbody spacer at this level, although this does not appear significantly changed since previous exams. A similar appearance is noted at L4-L5 level although to a lesser degree with moderate bilateral foraminal narrowing. There has been interval thickening of the ventral epidural tissue especially spanning the S1 level compared to the prior exam, with mild narrowing of the central spinal canal. This area of soft tissue now measures 9 mm in greatest thickness on 701/9, compared to previous 6 mm.
1.Interval development of discrete prevertebral collections at the L4-L5 and L5-S1 levels, to be further detailed on a dedicated MRI of the lumbar spine. Given the patient's history, these are suspicious for abscesses.2.Interval thickening of ventral epidural tissue especially at the S1 level, also concerning for infection.3.No MR evidence of cord compression, although there is now mild central spinal canal narrowing at the S1 level.4.Moderate bilateral foraminal narrowing at L4-L5 and L5-S1 secondary to encroachment by nonspecific soft tissue along the dorsal aspects of the interbody spacers.