Evaluate for cauda equina syndrome, low back pain and decreased urine output Five lumbar type vertebral bodies are presumed to be present. There is moderate chronic compression fracture involving the T12 vertebral body with approximately 70% loss of height; no associated bone marrow edema or interval loss of height compared to CT 3/1/2014. There is a mild compression fracture involving the L4 vertebral body with 20% loss of height with associated bone marrow edema and new since 3/1/2014. No associated osseous retropulsion into the spinal canal. Schmorl's nodes are noted at L2 and L3 similar to prior. Alignment is maintained. Conus is in normal position and with normal signal intensity.Multilevel degenerative changes are seen with disc desiccation and vacuum phenomena throughout, better appreciated on prior CT. Bone marrow signal is heterogeneous. More focal area of edema enhancement are noted involving the right L5 pedicle which may be on a degenerative basis. There is also abnormal signal with low T1 signal, T2 hyperintensity, and enhancement involving the right L3 transverse process which may be related to recent fracture versus underlying other osseous lesion.Individual levels as below:L1-L2: There is a disc bulge without significant spinal canal or neural foraminal stenosis.L2-L3: There is loss of disc height and disc bulge with central osteophyte and protrusion component resulting in mild central canal stenosis. No significant neural foraminal stenosis. L3-L4: Minimal disc bulge eccentric to the right and loss of disc height. Mild right neural foraminal stenosis. No spinal canal or left neural foraminal stenosis.L4-L5: Minimal disc bulge and loss of disc height. There is mild to moderate right neural foraminal stenosis and minimal left neural foraminal stenosis. No spinal canal stenosis.L5-S1: Minimal disc bulge. Severe loss of disc height. No significant spinal canal stenosis. Mild bilateral neural foraminal stenosis. No findings to suggest discitis-osteomyelitis or epidural or paraspinous abscess. Subcapsular lesion along the posterior aspect of the left kidney is again seen which may be related to prior hemorrhage.
1. No high-grade spinal canal stenosis is seen at any level to suggest cauda equina syndrome.2. Multilevel degenerative changes as detailed above with mild spinal canal stenosis at the L2-L3 level.3. Mild compression fracture involving L4 with edema suggesting acuity/recent loss of height.4. Chronic compression fracture at T12.5. Edema and enhancement involving the right L3 transverse process which may be related to underlying fracture versus other osseous lesion. CT may be helpful for differentiation. There is also focal enhancement involving the right superior L5 articular facet/pedicle which is nonspecific and may be on a degenerative basis or similar to process at L3.