Male, 61 years old, with epidural abscess on antibiotic therapy. Assess for changes. Evaluation of progressive abscess is compromised by lack of IV contrast. Within this limitation, the following observations are made.Since the prior examination, it appears that thickening of the ventral epidural soft tissues has progressed along the L5 and S1 vertebral bodies. This tissue now measures up to 12 mm in thickness, previously 8 mm. There is a greater degree of encroachment upon the spinal canal and thecal sac, particularly at the level of the L5-S1 disc space.Edema within the L5 and S1 vertebral bodies as manifest on STIR images seems to be mildly more conspicuous than on the prior examination. Similarly, inflammatory STIR hyperintensity within the anterior paraspinal soft tissues along L5 and S1 has increased.The remainder of the examination shows no significant interval change including mild to moderate degenerative findings. The visualized spinal cord and conus are unremarkable.
Without the benefit of IV contrast, it does appear that an infectious/inflammatory process within the ventral epidural space at L5 and S1 has expanded. The epidural soft tissues have progressively thickened and there is a greater degree of spinal canal encroachment. Edema within the L5 and S1 vertebral bodies, and in the anterior paraspinal soft tissues, has also slightly progressed.