History of lumbar diskitis/osteomyelitis in 2013. There are chronic changes related to prior discitis/osteomyelitis of the lower lumbar spine, with loss of the L3-4 disc, severe disc height loss at L4-5, and superimposed postoperative findings at these levels. There is also bony fusion of the L3-4 vertebral bodies. There is no disc or vertebral body enhancement to suggest current active infectious or inflammatory process. There is marked bilateral neural foraminal narrowing at L4-5 and mild bilateral neural foraminal narrowing at L3-4. At L2-3, there is diffuse disc bulge and extensive uncovertebral joint hypertrophy/ligamentum flavum thickening with associated severe spinal canal narrowing, as well as moderate bilateral neural foraminal narrowing at this level. There are subcentimeter peripherally enhancing fluid collections posterior to the bilateral L2-3 facet joints. At L5-S1, there is diffuse disc bulge with a left paramedian disc extrusion, leading to marked bilateral neural foraminal narrowing and moderate spinal canal narrowing. This is stable to slightly progressed from the prior study. The imaged portions of the spinal cord are unremarkable.
1.Degenerative changes at L2-3, with associated severe spinal canal stenosis, L4-5, with marked right neural foraminal narrowing, and moderate bilateral foraminal narrowing and at L5-S1, with marked bilateral neural foraminal narrowing and moderate spinal canal narrowing.2.Chronic changes related to prior discitis/osteomyelitis, with deformity of L4 and L5 and fusion of L3 and L4.3.Subcentimeter peripherally enhancing fluid collections posterior to the bilateral L2-3 facet joints may represent inflamed synovial cysts. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.