Bacteremia and back pain. There is degenerative spondylosis in the lower lumbar spine, including a disc extrusion at L5-S1 that is slightly eccentric to the left and severely narrows the spinal canal. In conjunction with facet hypertrophy, there is only mild narrowing of the bilateral neural foramina at L5-S1. In addition, mild high T2 signal and enhancement in the inferior L5 vertebral body, which is likely related to degenerative disease. There is a small disc protrusion with annular fissuring at L4-5 with slight spinal canal narrowing, but no neural foramen stenosis. There is a focus of high T1 and T2 signal with mild enhancement in the C2 vertebral body, which likely represents a hemangioma. Aside from intravertebral disc herniations in the lower thoracic and lumbar spine, the vertebral body heights are preserved. The vertebral column alignment is anatomic. There is a prominent retroperitoneal lymph node that measures up to 35 mm anterior to the L5 vertebral body. Enhancement of the surrounding prevertebral soft tissues may be treatment-related. Areas of pulmonary consolidation are better delineated on the body CT.
1. Degenerative spondylosis in the lower lumbar spine, with a disc extrusion at L5-S1 that severely narrows the spinal canal. 2. No evidence of infectious discitis-osteomyelitis or abscess in the spine.3. A prominent retroperitoneal lymph node likely represents metastatic disease.