History of prostate cancer now with weakness and known lumbar lesions of metastatic disease. Rule out cord compression. Diffuse bone marrow changes are present compatible with the patient's known diffuse osseous metastases. There are degenerative changes in the cervical spine, including disc-osteophyte complexes and ligamentum flavum thickening at multiple levels with chronic spinal canal narrowing but there is no evidence of cord signal abnormality or acute cord compression. Similarly in the thoracic spine no cord signal abnormality or cord compression is demonstrated. Degenerative changes and osseous metastases are present in the lower lumbar spine, especially involving the L3-4 and L4-5 levels. The exam in the lumbar spine is degraded by motion artifact. Given this, and the absence of contrast, mild epidural spread of metastatic disease cannot be excluded, though a high-grade canal stenosis is not highly suspected .
This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. Diffuse osseous metastatic disease and degenerative changes but no distinct evidence of cord compression is identified. The exam in the lumbar spine is degraded by motion and artifact and in the absence of contrast, mild epidural spread of metastatic disease cannot be excluded. However, no high-grade acute canal stenosis is suspected.