 Cervical spine: Examination is mildly motion degraded. Vertebral body heights in the cervical spine are normal. Alignment is normal. There is diffuse low T1 marrow signal without focal destructive lesions. No evidence of epidural tumor. No pathologic compression fractures. No cord signal abnormalityMild multilevel degenerative changes are seen with small disc osteophyte complexes from C2-C3 to the C6-C7 levels without significant spinal canal stenosis. No high-grade neural foraminal stenosis at any level.Thoracic spine:Diffuse low T1 marrow signal is again noted without focal destructive lesions. There are areas of T1 and T2 hyperintensity involving the left sided transverse processes in the mid and lower thoracic spine and were present previously and compatible with fatty change, possibly from prior left-sided radiation. The vertebral body heights and disc spaces are maintained. The spinal cord has a smooth contour and is without focal atrophy, edema, or myelomalacia. No significant spinal canal or neural foraminal stenosis. No evidence of compression fractures. No abnormal enhancement.Lumbar spine:The most inferior well-defined disc space is labeled L5-S1. Diffuse low T1 marrow signal again seen. There are multiple heterogeneously enhancing lesions involving the visualized pelvis. Prior lumbar spine MRI was without contrast limiting comparison. Vertebral body heights are normal without compression fractures. No discrete destructive lesions within the lumbar spine are appreciated. No abnormal epidural or leptomeningeal enhancement.Grade 2 anterolisthesis of L5 on S1 is again seen with evidence of osseous fusion posteriorly. Degenerative changes include disc desiccation at L4/5 and L5/S1 with mild disc height loss at L4/5 and moderate disc height loss at L5/S1. There is a small Schmorl's node involving the superior endplate of L5. Mild disc bulge and facet arthropathy at L4-L5 with facet effusions again seen. There is mild bilateral L5-S1 neural foraminal narrowing. Otherwise no significant spinal canal or neural foraminal stenosis in the lumbar spine.
Diffuse low T1 marrow signal throughout the spine as well as multiple enhancing lesions within the pelvis are compatible with history of multiple myeloma. No evidence of pathologic compression fractures or discrete destructive lesions within the cervical, thoracic, or lumbar spine. No evidence of epidural tumor. No significant spinal canal stenosis at any level. Mild degenerative changes as described above.