Right lower occipital weakness. Progressive back pain L3 fracture, stable L1 fracture, severe L3-L4 stenosis. Five lumbar type vertebral bodies are presumed to be present. There is a transitional anatomy at the L5 level with pseudoarticulation involving the left L5 transverse process with the sacrum with superimposed degenerative changes. Again seen is compression fracture involving the L1 vertebral body with approximately 50% loss of height. There is a severe compression fracture involving the L3 vertebral body with particular height loss in its mid aspect as seen on recent CT from 11/1/2016 and progressed since prior MRI from 6/5/2016. There is mild osseous retropulsion at both of these levels. Edema involving the L3 vertebral body is decreased compared to prior. There is a mild compression fracture involving the superior endplate of the L4 vertebral body with 20% loss of height which is new since prior from 6/5/2016 and grossly similar from recent CT. There is mild edema involving the superior L4 endplate. There is T1 shortening involving the L1 vertebral body as well as the pelvis which may be related to prior radiation.There is moderate to severe spinal canal stenosis at the L3-L4 level which is progressed since prior. There is fairly mild spinal canal narrowing at the L2-L3 and L4-L5 levels.Additional details as described below:L1-L2: No spinal canal stenosis. There is mild bilateral neural foraminal narrowing related to minimal disc bulge and bilateral facet arthropathy.L2-L3: There is mild spinal canal narrowing. There is mild right neural foraminal stenosis related to prominent right-sided facet arthropathy. Left neural foramen is patent.L3-L4: There is moderate to severe spinal canal stenosis related to combination of osseous retropulsion, disc bulge, ligamentum flavum thickening, and facet arthropathy. There is also severe right and moderate left neural foraminal stenosis, which have also progressed. L4-L5: Mild disc bulge and advanced facet arthropathy. There is mild narrowing of the spinal canal. There is moderate left and mild right neural foraminal stenosis similar to prior.L5-S1: There is a disc bulge and bilateral facet arthropathy, worse on the left. There is no spinal canal stenosis. There is mild to moderate, left relatively greater than right, neural foraminal stenosis which is similar to prior.No definite evidence of metastatic disease is evident within the limits of noncontrast study.
1. Compared to prior MRI from 6/5/2016, there is progression of a severe compression fracture of L3, new mild compression fracture of the L4 vertebral body, and unchanged moderate L1 compression fracture. These findings are similar to recent CT from 11/1/2016.2. At L3-L4, there is moderate to severe spinal canal stenosis, severe right neural foraminal stenosis, and moderate left neural foraminal stenosis. These findings have all significantly progressed since prior MRI from 6/5/2016.3. No definite evidence of metastatic disease is evident within the limits of noncontrast study. Additional levels as above.