59 yr f. recent mri shows white shadow on 20 y. healed compression fracture of t-11 mri was due to worsening chronic pain balance issues weakness dulled reflexes doctor suggests adding contrast dye to area. (medadjust?) 2nd opinion please?

Sounds reasonable: Normally, a healed vertebral fracture should have a marrow signal similar to normal bone, and so should not show a "shadow". The contrast will therefore give the radiologist the chance to characterize the area further to make sure it is not a lesion from a cancer, for example. A ct scan might also give further details. It sounds like getting the MRI with contrast is a reasonable next step.