Female, 73 years old, with multiple myeloma and new onset back pain. Cervical:A grade 1 retrolisthesis of C5 relative to C6 is seen. Alignment is otherwise unremarkable. Vertebral body heights are preserved. No pathologic marrow signal change or enhancement is detected. The visualized spinal cord demonstrates normal signal intensity and morphology throughout. No pathologic cord or leptomeningeal enhancement is seen.C2-3: Facet hypertrophy. Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild right foraminal narrowing. C3-4: Left sided facet hypertrophy. Posterior disc-osteophyte complex formation eccentric to the left foraminal region. No significant spinal canal stenosis. Moderate to severe left and mild right foraminal narrowing. C4-5: Left greater than right facet hypertrophy. Left ligamentum flavum thickening. Minimal posterior disc-osteophyte complex formation. Mild narrowing of the left aspect of the spinal canal. Moderate to severe bilateral foraminal narrowing.C5-6: Left facet hypertrophy. Posterior disc-osteophyte complex formation and disc uncovering. Mild generalized spinal canal narrowing. Severe bilateral foraminal narrowing. C6-7: Left greater than right facet hypertrophy. Mild posterior disc-osteophyte complex formation asymmetric to the right foraminal zone. No significant spinal canal stenosis. Moderate to severe right foraminal narrowing. C7-T1: Right greater than left facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or foraminal stenosis. Thoracic:Marrow signal characteristics are diffusely heterogeneous but there are no edema-inducing lesions and no evidence of any pathologic marrow enhancement.The thoracic kyphosis is mildly exaggerated likely due to mild anterior wedging from T4 through T9. Overall, vertebral body heights are preserved.The visualized spinal cord illustrates normal signal intensity throughout. No pathologic cord or leptomeningeal enhancement is seen. No epidural abnormalities are detected.At T2-3, a central disc protrusion minimally impinges upon the spinal cord but causes no significant spinal canal or foraminal stenosis.At T7-8, a moderately sized right paracentral disc protrusion slightly flattens the ventral spinal cord but causes no significant generalized spinal canal or foraminal stenosis.Lumbar:Marrow signal characteristics are diffusely and mildly heterogeneous. In addition, within the anterior aspect of the L1 vertebral body, there is a 6 mm well-circumscribed focus of enhancing marrow replacement. Vertebral body height and morphology are preserved. Trace anterolisthesis of L3 relative to L4 and L4 relative to L5 is seen. Elsewhere alignment is anatomic.The distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No pathologic cord or leptomeningeal enhancement is suspected. No epidural abnormalities are seen.T12-L1: Minimal facet hypertrophy. Minimal bulging disc. No significant spinal canal or foraminal stenosis.L1-2: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. L2-3: Mild facet hypertrophy. Mild laterally bulging disc. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L3-4: Moderate facet hypertrophy. Mild disc bulging and disc uncovering. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L4-5: Moderate facet hypertrophy. Mild disc bulging and disc uncovering. No significant spinal canal stenosis. No significant foraminal narrowing. L5-S1: Mild facet hypertrophy. No significant spinal canal or foraminal stenosis.
1.A single 6 cm focus of enhancing marrow replacement is seen within the L1 vertebral body which, although nonspecific, could represent an isolated site of myelomatous disease.2.Elsewhere no definite myelomatous lesions are seen.3.Relatively modest degenerative findings are seen. No areas of high-grade spinal canal stenosis are suspected. Significant neuroforaminal narrowing is, however, noted at multiple cervical levels.