update

With all the exams, I don't really have time to post much of anything thoughtful about my dad.  So I figured I would just post the email I sent him a couple of days ago regarding his current back issues.  A lot of doctorese.

This is the summary report of the MRI:

RADIOLOGY/ECHO: MRI: Findings:
There is a wedge compression fracture of nearly every vertebral body, without evidence of underlying enhancement and T2 signal abnormality. Augmentation procedures have been performed at L1 and L2. Extensive degenerative changes are present. Grade II anterolisthesis of L5 on S1 is noted. Because of the anterolisthesis, there is severe left L5 neural exit foramen narrowing and mild right L5 neural exit foramen narrowing. There is also severe left L4 neural exit foramen narrowing.
The nerve roots of the cauda equina appear mildly thickened, but there is no abnormal enhancement.
The conus ends at L1-L2.
A broad-based disk osteophyte complex is seen at L2-L3. There is no significant central spinal canal stenosis or neural foraminal narrowing.
L3-L4: Broad-based disk bulge. Mild bilateral lateral recess stenosis. Mild bilateral facet joint hypertrophy.
L4-L5: No significant central spinal canal stenosis or neural foraminal narrowing.
L5-S1: Neural foraminal narrowing as described above. No central spinal canal stenosis.

JOHN DOE, M.D

And here it is with my comments inserted in parentheses:

RADIOLOGY/ECHO: MRI: Findings:
There is a wedge compression fracture of nearly every vertebral body, without evidence of underlying enhancement and T2 signal abnormality (this is very concerning. Definitely a consult with orthopedics is warranted. But I also think seeing the endocrinologist is a good idea. Perhaps pharmacological management is just as effective).

Augmentation procedures have been performed at L1 and L2. Extensive degenerative changes are present (have they degraded more since your last MRI? We need to get an orthopedic consult to evaluate if degenerative changes are ongoing that rapidly. If they are, it would seem an agent like Zometa or Denosumab to inhibit bone turnover are warranted).

Grade II anterolisthesis of L5 on S1 is noted. Because of the anterolisthesis, there is severe left L5 neural exit foramen narrowing and mild right L5 neural exit foramen narrowing. There is also severe left L4 neural exit foramen narrowing. (this is the one that may require surgery. This is the slipping that the neurologist talked about. It's NOT a slipped disk. It's a slipped vertebra. The vertebrae are out of alignment. He said it was a grade 2 and the scale is 1 through 4 with 4 being the most severe. This isn't simple kyphoplasty anymore. This is neurosurgery. There's one thing Dr. Numbnuts did right by bringing in a neurologist. But it's not an emergency as of yet. It still needs to be paid close attention, though. Any change in your leg function, leg sensation, bowels or bladder needs to be assessed IMMEDIATELY.)

The nerve roots of the cauda equina appear mildly thickened, but there is no abnormal enhancement. (this is good. If this gets messed up, you lose control of your bowels and bladder. Then it's absolutely a surgical emergency, SCT or not. If you notice any loss of feeling, loss of function, you need to go to the ER and request a neurologist IMMEDIATELY.)

The conus ends at L1-L2.
A broad-based disk osteophyte complex is seen at L2-L3. (these are changes indicative of osteoarthritis. This is a chronic process, not an acute one.)

There is no significant central spinal canal stenosis or neural foraminal narrowing. (a good thing)

L3-L4: Broad-based disk bulge. Mild bilateral lateral recess stenosis. Mild bilateral facet joint hypertrophy. (this is an example of a bulging disk that may start to slip. I'm not sure what the last sentence implies. Hypertrophy is a response to some sort of inflammation. As to what's causing the inflammation, I don't know. Cancer? Arthritis? Regardless, I don't see how this is an acute finding. This is something that's been chronic.)

L4-L5: No significant central spinal canal stenosis or neural foraminal narrowing. (a good thing)

L5-S1: Neural foraminal narrowing as described above. No central spinal canal stenosis. (already described)