Clinical question: Acute L5 fracture with anterior/posterior fascicle involvement c/f instability. Signs and symptoms: Status post fall. Nonenhanced lumbar MRI:Examination demonstrate an acute wedge compression fracture of vertebral body of L5 anteriorly and with evidence of edematous changes of bone marrow. There is preserved normal anatomical alignment of compressed vertebrae and no evidence of spinal canal. Minimal left neural foraminal compromise secondary to degenerative changes is noted.There is no evidence of perispinal soft tissue abnormality with this finding. The maximum height of compressed fractured vertebrae measures at 9.9 -mm compared to maximum height of vertebrae posteriorly at 26.4-mm. There is intraosseous hemorrhage within the compressed vertebrae which minimally extend through the superior endplate into the disk space.There is no detectable epidural widening or abnormal signal intensity to suggest hemorrhage. There is no compromise of spinal canal T12 -- L1 and L1 -- L2 levels demonstrate mild degenerative changes and unremarkable otherwise.L2 -- L3 demonstrate mild disk disease and hypertrophic changes of facet/ligamentum flavum posteriorly. No central spinal stenosis or neural foraminal compromise. There is a chronic mild compression deformity of the superior endplate of L3.L4 -- L5 demonstrates above detailed which compression fracture of L5. L5 -- S1 demonstrate mild to moderate disk disease and loss of disk height without spinal stenosis. Mild left neural foraminal compromise secondary to degenerative changes is present.  This examination covers from T10 through S3. Examination of lumbar spine was performed as a complete MRI of the lumbar spine the study which includes all axial series. However due to patient's inability to continue and excess motion artifact the service was notified and the rest of the exam for evaluation of thoracic spine was not performed.Normal as visualized thoracic spine and thoracic cord from T10 inferiorly demonstrate no evidence of acute abnormality, no central spinal stenosis, no significant neural foraminal compromise and normal signal intensity of the cord.
1.Complete nonenhanced MRI of the lumber spine demonstrate more than 50% wedge shaped fracture of the anterior L5 vertebrae without evidence of spinal canal or neural foramina compromise. Intraosseous hemorrhage at the fracture site extends minimally into the disk space at L4 -- L5 level.2.Mild to moderate degenerative changes of lumbar spine otherwise however without spinal stenosis or any significant neural foraminal compromise.3.Almost visualized thoracic spine from T10 inferiorly is unremarkable with the exception of mild degenerative changes.4.Examination was terminated at this point due to patient's inability to continue.