 There are multiple enhancing lesions through much of the axial skeleton superimposed upon a background of fat signal in portions of the thoracic and lumbar spine, likely related to radiation therapy. There are postsurgical findings related to recent laminectomy at L3 and L4, with diffuse enhancement of the soft tissues in the surgical bed. There is mild protrusion of tumor posteriorly from the L3 vertebral body, which in conjunction with degenerative spondylosis markedly narrows the left L3-4 neural foramen. Otherwise, degenerative spondylosis results in narrowing of the right L3-4 and bilateral L4-5 neural foramina, as well as right lateral recess narrowing at L5-S1. There is a small central disc extrusion at T7-8 with no significant central spinal or foraminal stenosis. There are defects in the T12 through L4 endplates associated with tumor, most pronounced at L1 with 50 % loss of height centrally. The spinal cord appears unremarkable. There is no spondylolisthesis. There are bilateral renal cysts.
1.Lesions throughout the axial skeleton are compatible with multiple myeloma. The lesion at L3 is slightly expansile and narrows the left L3-4 neural foramen and left lateral recess in association with degenerative spondylosis. 2.Postoperative findings related to recent laminectomy at L3 and L4, with narrowing of the bilateral L3-4 and L4-5 neural foramina due to degenerative spondylosis.3.Defects in the T12 through L4 endplates associated with tumor, most notably at L1.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.