 The vertebral column alignment is within normal limits without sagittal spondylolisthesis. There is new mild anterior wedging and superior endplate deformity involving the L2 vertebral body. Within the L2 superior endplate, there is a linear band of decreased T1 signal, increased STIR signal compatible with bone marrow edema, and shows Gad enhancement. Constellation of these findings are most compatible with an acute compression fracture. There is no associated retropulsion into the spinal canal. Vertebral body heights are otherwise preserved. A few scattered small Schmorl's nodes and additional mild degenerative endplate changes are present. There are several foci of increased T1 and T2 signal within the lumbar vertebrae, sacral vertebrae, and iliac bones which are favored to represent hemangiomas or focal fat deposition. There is mild loss of disc height at L4-L5. The disks are diffusely desiccated. The spinal cord displays normal signal and morphology. The conus terminates at L1-L2. The paravertebral soft tissues are unremarkable.T12-L1: No significant central canal or foraminal stenosis.L1-L2: Mild disc bulge and facet hypertrophy without significant central canal or foramina stenosis.L2-L3: Mild disc bulge and facet/ligamentum flavum hypertrophy. Mild central canal stenosis. Right greater than left moderate foraminal stenosis.L3-L4: Mild disc bulge and facet/ligamentum hypertrophy. Mild central canal stenosis. Mild left foraminal stenosis.L4-L5: Mild disc bulge and facet/ligamentum flavum hypertrophy. Mild central canal and moderate bilateral foraminal stenosis.L5-S1: Mild disc bulge and facet/ligamentum flavum hypertrophy. No significant central canal or foraminal stenosis.
1.Findings most compatible with mild acute compression fracture of the L2 vertebral body without retropulsion. No definite source of infection is identified in the lumbar spine. Given history of fevers, recommend evaluation for alternate source of infection. Recommend consultation with the interventional neuroradiology for L2 kyphoplasty for the purpose of back pain reduction. Discussed by Dr. Lee with VERMA, ANSHU at 10:00 a.m. on 9/4/2015. 2.Multilevel degenerative changes as described above including mild central canal stenosis at L2-L3, L3-L4, L4-5 as well as scattered foraminal stenosis.