Female, 72 years old, with multiple myeloma and multiple compression fractures, presenting with new mid and lower back pain. Please note that an abridged examination was performed to accommodate the patient's discomfort during scanning.Severe compression deformities are evident at T5 and T7-T9, all showing evidence of prior kyphoplasty. The compression at T9 appears to have progressed slightly when compared to the prior MRI examination although the others are not significantly changed. There is mild retropulsion at the T5 level, similar to prior, which results in effacement of the ventral thecal sac but no significant spinal canal stenosis.Moderate to severe compression deformities are also evident at the T12-L5 vertebral bodies, all of which show evidence of prior kyphoplasty. There has been no significant change in the severity of these compressions. At the L4 level, there may be some degree of retropulsion which, combined with anterolisthesis of L3 relative to L4, results in a moderate generalized spinal canal stenosis with crowding of the cauda equina.Marrow signal characteristics are generally slightly heterogeneous. There are, in addition, several scattered focal areas of marrow replacement throughout the spine, some of which demonstrate corresponding enhancement. The largest focal enhancing lesion is found in the left sacrum.Multilevel disc osteophyte formation is seen in the cervical spine. This results in mild to moderate spinal canal narrowing from C3-4 through C5-6. Significant foraminal narrowing is evident on the left at C4-5.In the lumbar spine, disc uncovering at L3-4 with some component of L4 retropulsion, in combination with marked facet arthropathy and ligamentum flavum thickening, results in a moderately severe spinal canal stenosis. Milder disc degeneration is seen at other lumbar levels though the posterior elements are significantly degenerated at lower lumbar levels. The lumbar neural foramina are mildly to moderately narrowed.
1.Redemonstration of multiple compression deformities including at T5, T7-T9, and T12-L5. All demonstrate evidence of prior kyphoplasty.2.No new compression deformities are seen. The compression deformity at T9 has progressed slightly. The remaining compression deformities appear similar to prior examinations.3.Several scattered foci of marrow replacement are seen which may represent areas of active myelomatous disease. The largest such lesion is found in the left sacrum.