 There is transitional spinal anatomy. For the purposes of this exam, last fully formed disc is at L6-S1.There is developmental partial fusion of the C6 and C7 vertebrae on the left side, with overall diminutive appearance of the disc and decreased AP dimension of the C6 and C7 vertebral bodies. There is mild left foraminal narrowing at this level.There is redemonstration of a moderate-severe compression deformity involving T5 is predominantly left-sided with mild to moderate loss of height on the right. There does not appear to be significant progression since the prior MRI. Other scattered Schmorl's nodes appear similar and are not consecutive vertebrae. There appears to be a developmental abnormality involving the left posterior lateral T6 vertebral body which is diminutive and deformed, with medialization of the left costovertebral junction. The left pedicle is developmentally slender. There is moderate left foraminal narrowing at the T5-T6 level.There is redemonstration of segmentation anomaly involving L2 on L3 on the right side with single right-sided foramen and two on the left. There is disc desiccation on the right L1-L2 level, and to a lesser degree at L3-L4. There is mild developmental disc narrowing at L6-S1.Levoscoliosis is again noted of the upper lumbar spine. The spine is in normal sagittal alignment. The vertebral body and disk heights are otherwise well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. Apparent patchy hyperintense signal in the cervical cord on sagittal images is artifactual. The distal spinal cord and conus are within normal limits with the conus terminating at the L1-L2 level. There is no pathological enhancement, although sagittal T1 post contrast images are limited due to artifact indwelling dental hardware. Minimal enhancement along the ventral aspect of left T5 vertebral body in the area of fracture is likely reactive.There is a rightward predominant disc bulge at L1-L2 with mild right foraminal narrowing. There is mild-moderate developmental narrowing of the left L2-L3 foramen.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the remainder of spine. There is facet arthropathy and ligamentum flavum thickening along the lumbar spine.There is free fluid within the pelvis, which is likely physiologic. The bladder is well distended.
1.Transitional spinal anatomy with segmentation anomalies as detailed above. If surgery is to be contemplated, correlation with imaging of entire spine is recommended.2.Redistribution of moderate-severe predominantly left-sided compression deformity involving T5 without evidence of pathological enhancement. Minimal enhancement centrally likely is reactive. Associated moderate left foraminal narrowing at T5-T6.3.Previously questioned posterior T6 abnormality is favored to be developmental given the slender appearance of the left T6 pedicle.4.Other scattered mild foraminal narrowing as detailed above due to segmentation anomalies.