Post operative spondylodiscitis
Low back pain and bilateral sciatica more on the left. History of previous lumbar disc surgery 2 years ago
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There is L4 spinal laminectomy. L4-5 disc shows enhancement of its substances with edema and enhancement of the adjacent vertebral end plates and vertebral microabscesses as well as paravertebral and epidural enhancing inflammatory tissue that entangle L4 nerve roots at their foraminal inlet and left L5 nerve root at its lateral recess. Also there is element of arachnoiditis opposite L4-5 disc level
MRI is the modality of choice to diagnose spondylodiscitis as it can detect early changes occurs at the vertebral bodies or interventing disc also it can assess the paravertebral area and epidural region. Early inflammation of the disc is manifested by increase in its T2 signal intensity owing to increase its water contnents and avid post contrast enhancement.