Male, 61 years old, history of spinal abscess. Follow-up exam post antibiotics. Since the prior examination, ventral epidural thickening and enhancement along the L5 and S1 vertebral bodies has significantly improved with relief of spinal canal narrowing seen previously. No evidence of any residual epidural or paraspinal fluid collection is seen.Hyperintense STIR signal persists within the L5 and S1 vertebral bodies similar to the prior examination. Further degeneration of the L5-S1 disc space is also noted with slight progression of retrolisthesis of L5 relative to S1. The L5-S1 neural foramina demonstrate significant narrowing which has worsened, likely related to the progressive spondylolisthesis.No new areas of marrow signal abnormality are detected. Degenerative marrow signal change is seen anteriorly at the L3-4 endplates.Vertebral body heights are largely preserved. Except as above, spinal alignment is unremarkable. The visualized spinal cord, conus and nerve roots of the cauda equina are within normal limits.
1.Significant improvement in the degree of ventral epidural thickening and enhancement seen previously along the L5 and S1 vertebral bodies. No evidence of any residual epidural collection is seen. There is no longer any significant spinal canal stenosis at these levels.2.Persistent abnormal signal is noted within the L5 and S1 vertebral bodies. In addition, further destruction of the L5-S1 disc space with slight progression of spondylolisthesis is demonstrated. These findings are compatible with the chronic sequelae of osteomyelitis discitis.3.No new epidural or marrow space lesions are seen.