Male, 44 years old, with back pain and history of metastasis to the spine, evaluate for change of the lesion. A pathologic compression deformity of the L4 vertebral body with evidence of prior kyphoplasty is redemonstrated. Complete loss of vertebral body height is seen, similar to the prior examination. Retropulsion results in a similar mild degree of spinal canal stenosis particularly affecting the left lateral recess. As on the prior examination, there is severe narrowing of the left L4-5 neural foramen and moderate narrowing of the left L3-4 neural foramen.Signal abnormality and patchy enhancement involving the left L4 pedicle and transverse process have become less conspicuous than on the prior examination. A hemorrhagic cavity seen previously in the adjacent posterior paraspinal soft tissues has resolved. Generalized inflammation within the left posterior soft tissues has improved.A small sclerotic lesion within the T12 vertebral body is unchanged. A lesion within the L1 vertebral body has become more sclerotic than on the prior examination and perhaps slightly smaller. No new marrow space lesions are identified.
1.Stable pathologic compression deformity of the L4 vertebral body. This results in a mild generalized spinal canal stenosis with significant narrowing of the left L4-5 and L3-4 neural foramina, similar to that seen previously.2.Interval resolution of a hemorrhagic cavity seen previously within the left posterior paraspinal soft tissues. Inflammation in these soft tissues has also improved.3.A small sclerotic lesion in the T12 vertebral body is unchanged. A lesion within the L1 vertebral body has become more sclerotic and slightly smaller. No new osseous lesions are identified.