 Thoracic: The thoracic spine is in normal alignment. The vertebral body and disk heights are well-maintained. There is mild diffuse heterogeneity of the bone marrow which is nonspecific, but without discrete lesion to definitively suggest myelomatous involvement. The spinal cord is of normal caliber and signal. There is no pathological enhancement.There are mild degenerative changes in the thoracic spine including small disc bulges, facet arthropathy, and ligamentum flavum thickening. No significant disc herniation, spinal canal stenosis, or neural foraminal stenosis is appreciated.Advanced endplate degenerative changes are noted at the partially imaged C6-C7 level and to a lesser degree C7-T1 level, better assessed on prior complete spine study. No associated high-grade spinal canal stenosis is appreciated at this level.Lumbar: For the purposes of numbering, there are 5 lumbar type vertebral bodies. Vertebral body heights in the lumbar spine are normal. Alignment is grossly maintained. There is a 13 x 12 mm round T2 hyperintense lesion involving the posterior aspect of the left L2 pedicle/transverse process junction which is unchanged since 9/25/2014. There is otherwise diffuse heterogeneity of the bone marrow without a discrete destructive lesion to definitively suggest myelomatous involvement. Scattered foci of T1 hyperintensity are seen which may represent foci of fat or small hemangiomas. Schmorl's nodes are present involving the superior endplate of L3 and L4 and inferior endplate of L2, similar to prior. There is no significant spinal canal stenosis at any level. Conus demonstrates normal signal characteristics and terminates at a normal position.Mild degenerative changes include mild disc bulges at L2-L3, L3-L4, L4-L5, and L5-S1, mild facet arthropathy, and ligamentum flavum thickening. These findings are not appreciably changed since 9/25/2014. There is no significant spinal canal stenosis at any level. There is mild bilateral L3-L4 neural foraminal stenosis. There is mild right greater than left L4-L5 neural foraminal stenosis. No significant L5-S1 neural foraminal stenosis.Paraspinous soft tissues are grossly unremarkable.
1. There is no significant spinal canal stenosis at any level in the thoracic or lumbar spine to suggest compression of the cord or cauda equina.2. Diffuse heterogeneity of the brain marrow which is nonspecific and can be correlated with prior bone marrow biopsy. No definite imaging evidence of myelomatous lesions. There is a 13 x 12 mm T2 hyperintense lesion involving the posterior elements of L2 on the left which remains unchanged since 9/25/2014, which is nonspecific and may represent an atypical hemangioma--although myelomatous lesion remains a less likely possibility.3. Mild degenerative changes in the thoracic and lumbar spine including mild bilateral neural foraminal stenosis at L3-L4 and L4-L5, not significantly changed since 9/25/2014.4. More advanced degenerative changes in the cervical spine are better assessed on prior dedicated cervical spine MRI from 9/25/2014, including cervical cord signal abnormality related to myelomalacia.