• There is destruction of the endplates adjacent the L1-L2 disk with minor focal kyphosis, partial destruction of the adjacent vertebral bodies and a large posterior epidural mass which is resulting in compression of the cauda equina.
• There is also extension of the infective process into the right psoas muscle distally as far as the L4-L5 disk level and proximally to the T12-L1 disk level. The features would be quite consistent with a diagnosis of tuberculosis.
• The remainder of the spine is intact with no other infected vertebra or disk identified but there is widespread cervical, thoracic and lower lumbar degenerative disk disease. There are minor disk bulges at several levels but there is no significant cervical or thoracic canal compromise and the cord appears normal throughout. At L4-L5, there is a very minimal degenerative spondylolisthesis with advanced bilateral L4-L5 facet osteoarthritis and moderate central canal compromise. There is no lesion within the presacral space but the bladder is noted being grossly distended.
• Conclusion: The MR appearances are in keeping with TB spondylodiscitis along with paravertebral abscesses