 There is stable mild grade 1 retrolisthesis of L4 on L5. The spine is in otherwise normal alignment. The vertebral body heights are well-maintained. There is mild scattered disc narrowing throughout the cervical spine, with redemonstration of moderate-severe disc narrowing at L4-L5 with vacuum phenomenon.Prominent endplate degenerative marrow changes are seen again at L4-L5. Multiple areas of abnormal marrow signal are again visualized, with increased size and conspicuity of rounded areas and punctate foci of T1 and T2 hypointensity consistent with sclerosis. The largest lesion in the lumbar spine is now located at L1 along its superior endplate, increased in size since the prior MRI. There is slight associated convexity of the superior endplate due to the metastasis. A prominent area of T1 and T2 hypointensity corresponding to a sclerotic lesion is seen in the T8 vertebral body, similar to prior CT. Some of the lesions demonstrate mild peripheral STIR hyperintensity. Heterogeneous STIR hyperintensity is noted in the T1 vertebral body.The spinal cord is grossly of normal caliber and signal. There is at most mild central spinal canal stenosis at C4-C5 and C5-C6 with a focal central disc protrusion at C5-C6. Along the thoracic spine, there is a minimal shallow central disc protrusion at T9-T10 which indents the sac and may abut the ventral cord. Along the lumbar spine, there is redemonstration of focal spondylotic changes from L2-L3 through L4-L5 resulting in moderate-severe central spinal canal stenosis at these levels as previously seen. Grossly on sagittal images, the degree of narrowing appears similar. Scattered moderate foraminal narrowing is again noted along the lumbar spine.Mild STIR hyperintensity is noted along the left paraspinal musculature at the lumbosacral junction which may relate to postprocedural changes following recent steroid injection. There is no focal fluid collection identified.
1.No evidence of overt cord compression or evidence of acute pathologic compression deformity. Grossly similar degree of high-grade central spinal canal stenosis at L3-L4 and L4-L5 as previously seen, with significant crowding of cauda equina nerve roots. This is in part relating to grade 1 retrolisthesis of L4 on L5, which is stable.2.Compared to prior remote MRI of the lumbar spine, progressed size and conspicuity of sclerotic appearing osseous metastatic lesions within the spine. Findings do appear slightly progressed since more recent prior CT.3.Minimal signal changes along left lumbosacral paraspinal musculature which may relate to recent procedure. Please correlate clinically.