Multiple myeloma not having achieved remission [C90.00], Reason for Study: ^Reason: myeloma with compression fracture L3 and screws for surgery L5/S1 with persistent pain at that site History: see above Cervical spine:Normal cervical lordosis has been lost but straightened. Multifocal cervical vertebral bodies show high signal intensity on T2 and FLAIR imaging could indicate myeloma involvement. However, there is no evidence of acute compression fracture. There is no evidence of abnormal spinal cord signal intensity on the scan.There is a central focal protrusion of C34, C4-5 which abuts the thecal sac. In addition, at the level of C5-6 and C6-7 shows diffuse broad-based disc protrusion which results mild to moderate spinal canal stenosis.Thoracic spineNormal thoracic kyphotic angulation is seen.Spinal cord signal intensity is normal.Vertebral bodies show multifocal T2/FLAIR high signal foci which may indicate possible myeloma involvement. There is no evidence of neuroforaminal stenosis or spinal canal stenosis.Lumbar spine MRIThere is about 30% vertebral height reduction of L1 vertebral body with bone marrow edema indicating acute/subacute compression fracture.There is no evidence of retropulsion.There is evidence of prior PMMA injection at the level of L3.There is also evidence of L5-S1 external fixation with screws and rods. The conus medullaris terminates at the level of T12. Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: minimal bulging of disc, no neuroforaminal narrowing or spinal stenosis. Bone marrow edema with about 30% of vertebral height reduction indicate acute/subacute compression fracture.L2-L3: diffuse bulging of disc with bilateral ligamentum flavum thickening results mild to moderate spinal stenosis. L3-L4: diffuse bulging of disc with bilateral ligamentum flavum thickening results mild to moderate spinal stenosis. L4-L5: diffuse bulging of disc with bilateral ligamentum flavum thickening results mild to moderate spinal stenosis. L5-S1: diffuse bulging of disc, no neuroforaminal narrowing or spinal stenosis.
1. Acute/subacute compression fracture at the level of L1.2. Multifocal multilevel cervical and thoracic vertebral body lesions indicating possible myeloma involvement. 3. Spinal cord signal intensity is normal.4. Mild to moderate spinal stenosis at the level of C56 and C67.5. Mild to Moderate spinal canal stenosis, from L23 to L45.6. Post PMMA injection status of L3 and external fixation with rods and screws between L5 and S1.