• There is a large lobulated 70x118x103mm (TRxAPxCC) CSF signal collection arising from the bilateral L1/L2 laminectomy site. The collection crosses over both laminectomy sites, tracking posteriorly where it circumferentially envelops the L1 and L2 spinous processes and further extends into the paraspinal subcutaneous soft tissues and skin surface. The collection displays CSF signal on all pulse sequences with just minimal internal debris, and a low signal peripheral rim. It displays convincing T2 shine through indicating a large fluid component, this is further supported by a thin rim of peripheral enhancement. No areas of restricted diffusion are seen to imply acute infection. The collection is centred around a prominent focus of epidural fat at the level of the L-1/L-2 disc.
• No convincing intradural haematoma is identified. The collection mildly compresses the ventral thecal sac at L1 and L2 with a small focus of intrinsic high signal at the inferior aspect of L1. The latter is slightly more prominent when compared to the March study. However no overt cauda equina nerve root compression is seen.
• There is moderate surrounding soft tissue oedema, most pronounced in the paraspinal soft tissues. However no further proximal or distal collection is identified. Otherwise there is prominent bilateral T11 and T12 facet joint degenerative disease compressing the thecal sac with no overt nerve compression. There is moderate foraminal narrowing at both levels bilaterally. Normal appearances of the remaining cervical and thoracic spine.
• Conclusion: Large postsurgical pseudomeningocele arising from the L1/L2 laminectomy site extending to the skin surface as described above. No haematoma or signs of an infected collection seen.