55-year-old male with history of renal cell carcinoma with back and leg pain, evaluate for metastases. Recent tumor resection and orthopedic fixation There is been an interval laminectomy of L1 through L4 and posterior fusion of L1 through L5 with posterior stabilization rods, bilateral screws entering the pedicles of L5, L2 and L1 and right-sided screws entering L3 and L4. Artifact limits the evaluation of these levels. There is edema in the paraspinal and posterior soft tissues. Alignment is anatomic. There is subtle nonenhancing soft T1 hypoattenuation along the left posterior aspect of the L3 and L4 vertebral bodies which may represent edema or residual tumor. Vertebral body heights are intact. Mild multilevel disk desiccation. Signal within the distal cord and conus is normal. L1-L2: No central or neuroforaminal stenosis.L2-L3 No central or neuroforaminal stenosis.L3-L4: No central or neuroforaminal stenosis.L4-L5: No central or neuroforaminal stenosis.L5-S1: Mild diffuse disk bulge. No central or neuroforaminal stenosis.Large heterogeneous enhancing left renal mass is partially visualized.
1.Postsurgical changes tumor resection and posterior spinal fusion.2.Subtle T1 hypoattenuation along the posterior aspects of the L3 and L4 vertebral bodies may represent residual tumor or edema.