 Thoracic spine:Compared to the MRI performed 10 hours prior, there is new T2 hyperintensity in the left lateral aspect of the cord at the T5 level compatible with edema. In comparison with same day CT, the previously noted epidural abnormality corresponds at least predominantly to a bone fragment with minimal associated blood products. There is mild associated deformity of the left dorsal thecal sac at the T5 level, which is similar to prior.Stable height loss and STIR hyperintensity involving the T5 vertebral body. The remaining vertebral body heights are grossly preserved. Heterogeneous marrow signal is compatible with a history of multiple myeloma. Mild multilevel degenerative changes including mild spinal canal stenosis at T10-11 related to degenerative changes is unchanged. Additionally, there is mild facet arthropathy and ligamentum flavum calcification at T10-11. There is mild bilateral neural foraminal narrowing at T4-5 and T5-6, right greater than left. Paraspinal soft tissue edema is present which may be postprocedural.Lumbar spine:There is no evidence of epidural collection to suggest epidural hematoma.Alignment of the lumbar spine is within normal limits. The vertebral body heights are grossly preserved. The marrow signal abnormality has improved overall with less discrete osseous lesions compared to 4/22/2015. For example, the right iliac lesion has slightly decreased in size. There is no evidence of epidural tumor within the limits of noncontrast technique. Degenerative spondylosis affects the lumbar spine worst at L3-4, L4-5, and L4-5, at which levels there is disc desiccation. The distal cord and conus medullaris are normal in signal and caliber. The conus terminates at the L1-2 level. There is mild fatty atrophy of the paraspinal musculature. The visualized intra-abdominal contents are within normal limits.T12-L1: Minimal disc bulge without spinal canal stenosis or neural foraminal narrowing.L1-2: Minimal disc bulge without spinal canal stenosis or neural foraminal narrowing.L2-3: Minimal disc bulge, facet arthropathy, and ligamentum flavum thickening with mild spinal canal stenosis but no significant neural foraminal narrowing.L3-4: Mild disc bulge, facet arthropathy, and ligamentum flavum thickening with mild spinal canal stenosis. Mild to moderate bilateral neural foraminal narrowing. L4-5: Mild disc bulge, facet arthropathy, and ligamentum flavum thickening with mild spinal canal stenosis. Moderate bilateral neural foraminal narrowing. 11 x 9 mm T2 hyperintense focus compatible with a synovial cyst within the right neural foramen extends into the lateral recess, which appears slightly larger compared to the prior exam, and possibly impinges upon the exiting right L4 nerve root.L5-S1: Mild disc bulge and facet arthropathy without spinal canal stenosis. Minimal bilateral neural foraminal narrowing.
1. Compared to the MRI performed 10 hours prior, there is new T2 hyperintensity in the left lateral aspect of the cord at the T5 level compatible with edema. In comparison with same day CT, the previously noted epidural abnormality corresponds at least predominantly to a bone fragment in the left dorsal epidural space with minimal associated blood products. There is mild associated deformity of the left dorsal thecal sac which is similar to prior.2. No evidence of epidural collection in the lumbar spine.