Multiple myeloma not having achieved remission [C90.00], Reason for Study: ^Reason: New dx MM, lumbar vertebral fracture, eval for disease burden History: see above C-Spine:Loss of normal cervical lordosis was seen.Spinal cord signal intensity is normal.Multi-level intervertebral disc dessication with osteophytes indicating degenerative changes which includeC23: within normal limitsC34: diffuse bulging of disc with posterior longitudinal ligament calcifications. no spinal canal stenosisC45: Central to left disc protrusion which abuts thecal sac and shows mild spinal stenosis.C56: diffuse bulging of disc associated with central to left disc protrusion which abuts thecal sac and shows mild spinal canal stenosis.C67: diffuse bulging of disc, otherwise unremarkable.C7T1: diffuse bulging of discThoracic spine:There is normal thoracic kyphosis and lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The cord signal is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal stenosis, cord compression or myelopathy. L Spine:There are vertebral body lesions involving L1 and S1 which replacing normal fatty marrow. Especially the S1 lesion shows about10-20% of compression.There is about grade 1 spondylolisthesis of L5 on S1.Degenerative changes show;L1-L2: There is myeloma lesion on the posterior superior aspect of the L1 vertebral body. Otherwise unremarkable.L2-L3: Diffuse bulging of disc.L3-L4: Diffuse bulging of disc.L4-L5: Diffuse bulging of disc with bilateral ligamentum flavum thickening results mild spinal cord stenosis.L5S1: Grade 1 spondylolisthesis of L5 on S1 with pseudobulging of disc results mild spinal stenosis.S1-S2: Diffuse bulging of disc.
1. Degenerative changes of cervical spine with multilevel various degree spinal canal narrowing. Normal spinal cord signal intensity.2. Normal thoracic spine MRI4. Myeloma involvement of the L1 and S1 vertebral body with pathologic compression fracture of S1.5. Degenerative changes of lumbar spine/Comment: if S1 compression fracture is symptomatic, percutaneous cement augmentation can be considered. If indicated, please contact neurointerventional radiology service.