Status post lumbar spine surgery. There are new postsurgical changes since the prior MRI study, with hardware related to posterior spinal fusion from L2 to S1 levels. Postsurgical changes of anterior L2 -- L3 to L4 -- L5 interbody fusion are also present. There is a surgical drainage catheter in the posterior surgical bed. The orthopedic hardware generous streak artifacts, causing obscuration of image details in the surrounding area. This is small fracture at the right inferolateral aspect of the L4 vertebra, extending from the right L4 pedicle screw placement. Again noted is widening of anterior L1 -- L2 intervertebral disk space, with sclerotic endplate changes and air within the intervertebral disk space. This is similar in appearance to the prior MRI study. This may be related to severe degenerative disk disease; diskitis is less likely given the lack of interval change compared to the prior MR study, but this cannot be excluded.
1. New postsurgical changes as described above. There is a fracture at the right inferolateral aspect of L4 vertebra, extending from the right L4 screw placement.2. Residual degenerative disease as described above. There remains sclerotic endplate changes with bone erosion at endplates of L1 -- L2 level, likely representing severe degenerative disk disease. Diskitis is less likely but is not completely excluded.