can u explain these results in normal terms

[WoLfiE26]

hello i was wondering if you would be so kind as to explain my sons test results to me in terms i can understand.
his neuro said all tests came back normal but what is said here differs. on his mri he had last year it said,
the visualized portions of the orbits and paranasal sinuses are unremarkable with the exception of a small amount of fluid with in the mastiod air cells.
and his spinal x-rays that he just had last month its says:
i see posterior fusion defect at L5 and on the supine film there is a broad curvature of the spine convex right in the lumbar area.
my son is 5yo who is a twin and they were born 11 weeks premature.he has severe speech and articulation difficulty and has low muscle tone in the face, also has been complaining of pack pain and leg pain. he also has potty training issues where he seems to not realize he is going in his pants . he is in kindergartin as well .
thank you in advanced
wolfie

[WoLfiE26]

ty for your quick reply. his twin has no problems other then a clubbed foot and that has resolved. i'm sorry i forgot to say the exact wording on the spinal xray. it says
there is a broad curvature of the spine, convex right in the lumbar area.
we also have a genetics specialist who at first was questioning VCFS in him. but his blood test for the 22q11 deletion was negative and its my understanding the 17% of kids with actual VCFS do have a negative test because the mutation of the chromosomes is smaller than they can detect. he also has a ped neuro and a gastroenterologist as well as an ENT he has had 3 surgeries all 3 were tubes in his ears and has had his adnoids and tonsils removed as well.

again thank you wolfie

[CCF-Neuro-M.D.-JT]

I'm sorry to hear about your son's developmental delay. It's difficult to accurately comment on films that I don't personally review, but I'll do my best from the report. The breakdown of his films are as follows:mastoid air cells are part of your sinuses, so the MRI of the brain which shows fluid in there just means he probably has a little sinus fluid (which comes and goes) that is not necessarily sinusitis. Nothing to worry about. Found incidentally in many normal patients.

The spinal films describe what is probably spina bifida, a condition in which the vertebral bones (which make up the spine) don't completely form the arch we all have as part of the spinal cord's bony cage. At that particular segment L5 which is the lower back, his arch is incompletely formed. The broad curvature of the spine ??convex right?? may represent scoliosis. The exact wording from the report here is extremely important, so the paraphrased report prevents me from completely understanding it.

Your son may need further workup in terms of blood and urine studies to evaluate his developmental delay. If his twin is also affected, I would be concerned about a genetic problem. Consider seeing a pediatric neurologist for help. Best of luck.