Bilateral lower extremity weakness, unable to ambulate, known T12 compression fracture. Metastatic renal cell cancer. Compared to 6/25/2015, there has been worsening of vertebral body height loss involving the T12 vertebral body. There is increased osseous retropulsion and development of severe spinal canal stenosis at this level. Compared to prior, the posterior thecal sac is now effaced. Increased kyphosis is also noted at this level.There is evidence of diffuse osseous metastatic disease with multiple additional levels of bone marrow signal abnormality noted including the T1, T3, T8, and T9, and multiple lumbar vertebral bodies. No significance spinal canal stenosis is seen aside from the T12 level.
Evidence of osseous metastatic disease at multiple levels in the thoracolumbar spine with interval worsening of the severe pathologic compression fracture involving the T12 vertebral body with worsened spinal canal stenosis, deformity of the lower thoracic cord, and kyphosis at this level.Please note limited sequences were obtained for this exam per acute cord compression protocol.Dr. Ali discussed findings with Dr. Jelinek at 0908 hours on 8/6/2015.