New onset lower back pain, evaluate for compression fracture. Five lumbar type vertebral bodies are presumed to be present. Again seen are compression fractures throughout the lumbar spine as well as the partially imaged lower thoracic spine. There is evidence of cement augmentation from the T12 through the L5 levels. Compared to 7/8/2016 there has been development of a mild compression fracture involving the superior endplate of the T11 vertebral body with minimal loss of height involving the mid aspect of the superior endplate. There is mild edema involving the superior aspect of the T11 level. In the interval, there has also been subtle worsening of height loss involving the L3 compression fracture involving the anterior aspect of the superior endplate, better seen on the T1-weighted sequence with bone cement now contacting the superior endplate. There is minimal edema involving the superior anterior endplate of L3 which is slightly decreased in the interval. Bone marrow edema involving the superior aspect of the T11 vertebral body is new. Remainder of the compression fractures are not appreciably changed. As seen before, there is mild retrolisthesis associated with the L4 compression fracture with up to moderate degree of spinal canal stenosis in association with the ligamentum flavum thickening and bilateral facet arthropathy. The degree of spinal canal stenosis is not significantly changed in the interval. Alignment of the lumbar spine is also not significantly changed including grade 1 anterolisthesis of L3 on L4.Multilevel degenerative changes also include mild multilevel disc bulges and moderate facet arthropathy throughout the lumbar spine. Aside from the L3-L4 level there is no high-grade spinal canal stenosis. Mild multilevel neural foraminal stenosis is present at all levels without high-grade foraminal stenoses at any level.Diffusely heterogeneous marrow signal is again noted. STIR hyperintense lesions are noted involving the left aspect of the sacrum and compatible with history of multiple myeloma. These lesions aren't completely imaged on this lumbar spine study.
1. Compression fractures involving all lumbar vertebral levels and the imaged T11 and T12 thoracic vertebral bodies. The T11 compression fracture involving the superior endplate is new and associated with minimal height loss. There is mild edema at this level, which is new.2. Minimal worsening of L3 compression fracture is also suspected. Remainder of the chronic compression fractures are not significantly changed. Retropulsion at the superior L4 level with moderate spinal canal stenosis at L3-L4 is also not significantly changed.3. Heterogeneous marrow signal abnormality again seen. STIR hyperintense lesions involving the left aspect of the sacrum are partially imaged but present previously and compatible with known multiple myeloma.