 The patient has undergone interval laminectomy with posterior fusion from C2 - C5. Artifact from surgical screws is noted along with postsurgical change in the paraspinal soft tissues, but no abnormal fluid collection is seen. There are diffuse osseous metastases in the vertebral bodies and pedicles which have increased from the prior examinations. The largest of these lesions is an expansile, enhancing metastasis in the C2 vertebral body measuring approximately 41 x 26 mm and causing compression of the pre-vertebral soft tissues. Additionally, there is abnormal marrow signal with loss of vertebral body height of C5. There is narrowing of the spinal canal between C5 and C7 with asymmetric, severe narrowing of the spinal canal on the right at C6/C7 and mildly increased cord signal. There is no abnormal dural or leptomeningeal enhancement. There is moderate stenosis of the C6/C7 left neural foramen and mild stenosis of the C7/T1 left neural foramen. There is severe stenosis of the C6/C7 and C7/T1 right neural foramina.
1.Progression of diffuse osseous metastases in the vertebral column.2.Severe, asymmetric narrowing of the spinal canal at C6/C7 with right hemicord compression.3.Since 1/2015, interval laminectomy with posterior fusion from C2 - C5, no evidence of post-surgical complication.4.New pathologic fracture with loss of vertebral body height of C5.