Findings:
There is an L4 vertebral acute to subacute burst fracture with approximately 50% height loss and surrounding soft tissue edema and stranding. This fracture results in 4mm retropulsion of the posterior aspect of the vertebral body. The fracture also extends into the bilateral pedicles. There is vacuum phenomenon in the L3-L4 disc space. There is severe left and moderate right neural foraminal stenosis at L4-L5. There is also mild to moderate bilateral neural narrowing at L3-L4. There is advanced facet disease with joint space widening at L3-L4 and L4-L5. There is extensive degenerative osteochondrosis throughout the lumbar spine.

Impression:
Acute burst fracture of the L4 vertebral body with 4mm of retropulsion resulting in spinal canal stenosis. The fracture also extends into the bilateral pedicles, resulting in three-column injury.

Recommendations:
For your training purposes, recommendations are not included in this report.