Male, 78 years old, with multiple myeloma and worsening lumbar L1 pain for one week. Spinal alignment is grossly anatomic. Endplate concavity and a Schmorl's node deformity superiorly along L1 are unchanged. The remaining vertebral bodies demonstrate preserved height. Minimal edema is seen along the posterior superior L5 endplate, likely degenerative in nature. No focal marrow replacing lesions are seen. The visualized distal spinal cord and conus are within normal limits. The nerve roots of the cauda equina disperse evenly through the thecal sac. No epidural lesions are suspected.L1-2: Facet arthropathy. Ligamentum flavum thickening. No spinal canal or foraminal stenosis. No interval changes. L2-3: Facet arthropathy. Ligamentum flavum thickening. No spinal canal or foraminal stenosis. No interval changes. L3-4: Facet arthropathy. Ligamentum flavum thickening. Minimal disc bulging and minimal superimposed central protrusion. No significant spinal canal or foraminal stenosis. No interval changes. L4-5: Facet arthropathy. Ligamentum flavum thickening. Disc bulging asymmetric to the left. Effacement of the left lateral recess, perhaps slightly worse than on the prior exam. Mild left foraminal narrowing. L5-S1: Facet arthropathy. Ligamentum flavum thickening. Mild disc bulging with perhaps a right paracentral protrusion. No spinal canal stenosis. Moderate right and mild left foraminal narrowing. No interval changes. Edema and streak-like lesions are seen within the left iliac bone which may be related to bone marrow aspiration.
1.No definite evidence of any focal myelomatous disease is seen.2.Endplate concavity and a Schmorl's node deformity superiorly at L1 are unchanged.3.Relatively mild disc degeneration and posterior element hypertrophy are seen. No high-grade spinal canal stenosis is detected. Moderate foraminal narrowing is seen on the right at L5-S1.