Female, 59 years old, with back pain and vertebral body compression deformity. Thoracic:The thoracic kyphosis is slightly exaggerated, but sagittal alignment is unremarkable. Vertebral body heights are preserved. No evidence of marrow replacement or marrow edema is seen. The visualized spinal cord shows normal signal intensity and morphology. No epidural abnormalities are suspected. Minimal degenerative disc findings are seen with no significant compromise of the spinal canal or neural foramina.Lumbar:A compression deformity of the L1 vertebral body is seen with approximately 45% loss of vertebral body height. The marrow is diffusely edematous. Mild retropulsion of the vertebral body is seen along with a right paracentral extrusion of the L1-2 disc. Both findings cause mild effacement of the ventral thecal sac but no significant spinal canal stenosis or cord impingement.The remaining vertebral body heights are preserved. Again seen is evidence of posterior instrument fusion from L4 through S1. A grade 1 anterolisthesis of L4 relative to L5 is unchanged. Alignment is otherwise unremarkable. The distal spinal cord and conus are within normal limits. Rather than layering dependently, the nerve roots of the cauda equina appear to be suspended within the thecal sac (see image 19 series 18). Some of the cauda equina roots also appear to be clumped towards the right aspect of the thecal sac.L1-2: Right paracentral disc extrusion causing focal effacement of ventral thecal sac but no significant generalized spinal canal stenosis. The neural foramina are patent. L2-3: Unremarkable. L3-4: Unremarkable. L4-5: Postoperative findings. No significant spinal canal compromise. Mild right foraminal narrowing. L5-S1: Postoperative findings. No significant spinal canal stenosis. Mild right foraminal narrowing.
1.A compression deformity of the L1 vertebral body is seen with approximately 45% loss of vertebral body height. There is mild associated osseous retropulsion as well as a disc extrusion at L1-2. No significant spinal canal stenosis is seen.2.Redemonstration of findings compatible with posterior instrumented fusion from L4 through S1.3.The nerve roots of the cauda equina do not layer dependently but rather appear to be suspended within the thecal sac. This could reflect prior arachnoiditis with nerve root clumping, adhesions, or less likely, some sort of intradural cyst.4.No significant abnormalities detected in the thoracic spine.