67 year-old with multiple myeloma and history of compression fractures. Cervical spine:The vertebral body heights are preserved. Alignment is anatomic. No compression deformity is evident. There is diffuse loss of vertebral disc signal compatible desiccation as well as loss of disc height at C6-7. The bone marrow is heterogeneous throughout which is nonspecific but compatible with the history of myeloma. No abnormal enhancement.C2-C3: No disc bulge, spinal canal stenosis, or neuroforaminal narrowing.C3-C4: Trace disc osteophyte complex. No significant neural foraminal or spinal canal stenosis.C4-C5: Small disc osteophyte complex asymmetric to the right and uncovertebral joint hypertrophy. Mild right neural foraminal narrowing. No significant spinal canal or left neural foraminal narrowing.C5-C6: No disc bulge, spinal canal stenosis, or neuroforaminal narrowing.C6-C7: Moderate disc osteophyte complex with a superimposed left paracentral disc protrusion and uncovertebral joint hypertrophy. Mild left neural foraminal stenosis. No significant spinal canal or right neural foraminal stenosis.C7-T1: No disc bulge, spinal canal stenosis, or neuroforaminal narrowing.Thoracic spine:There are mild anterior wedging deformities at T7, T8, and T9 with approximately 25% loss of anterior vertebral body height. This creates an exaggeration of the thoracic kyphosis. Additional central endplate compression deformity of the T3 and T12 vertebral body accounting for approximately 20% of the vertebral body height. Alignment is maintained. Mild diffuse loss of intervertebral disc height and signal compatible with degeneration. This is associated with multiple Schmorl's nodes in the lower thoracic spine The bone marrow is diffusely heterogeneous throughout which is nonspecific but can be seen in myeloma. No abnormal enhancing lesions. Note is made of several mildly prominent mediastinal and retroperitoneal lymph nodes seen better on recent PET scan. No significant disc bulges, spinal canal stenosis, or neural foraminal narrowing in the thoracic spine.Lumbar Spine:There are 5 true lumbar type vertebral bodies with an additional transitional vertebra which for the purpose of this exam will be labeled S1. Post surgical changes from L3-4 interbody fusion and posterior stabilization. Metallic artifact mildly limits evaluation at this level. The vertebral body heights are maintained. Alignment is anatomic. The bone marrow is diffusely heterogeneous throughout with more focal lesions in the iliac bones compatible with the history of myeloma. There is a more focal high T1 and high T2 focus in the L1 vertebral body which suppresses on the STIR images compatible with an intraosseous hemangioma. There is diffuse loss of intervertebral disc signal compatible with desiccation and degeneration. Large aortocaval lymph node measuring 2.3 cm in diameter as seen on prior PET scan. No abnormal enhancement.T12-L1: No disc bulge, neural foraminal stenosis, or spinal stenosis.L1-L2: Trace disc bulge. No spinal canal or neural foraminal stenosis.L2-L3: Diffuse disc bulge slightly asymmetric to the left. Hypertrophy of the ligamentum flavum. Mild left neural foraminal stenosis.L3-L4: Postsurgical changes from posterior spinal fusion. Enhancing granulation tissue fills the neural foramen. There is moderate residual right neural foraminal stenosis. No significant spinal canal or left neural foraminal stenosis.L4-L5: Mild diffuse disc bulge. Mild hypertrophy of the ligamentum flavum. No significant neural foraminal or spinal canal stenosis.L5-S1: Mild diffuse disc bulge. Mild hypertrophy of the ligamentum flavum. No significant neural foraminal or spinal canal stenosis.
1. Diffusely heterogeneous bone marrow signal with some areas of more geographic patchy low T1 signal compatible with the history of multiple myeloma.2. Compression deformities involving the T3, T7, T8, T9, and T12 vertebral bodies with a maximum of 25% loss of intervertebral disc height. No associated compromise of the spinal canal3. Multilevel spondylitic changes which are most notably at L3-4 where there is moderate right neural foraminal stenosis.