Status post T4 laminectomy. Bilateral lower extremity weakness. Assess for hematoma or cord compression. The study is limited by patient motion. There are postoperative findings related to recent T4 decompression. The fluid collection in the posterior paraspinal T4 laminectomy bed has slightly increased in size since the previous examination and now maximally measures on the axial postcontrast images 3.2 cm x 1.4 cm. Otherwise, the height loss and epidural tumor extension at T4 resulting in considerable compression of the thecal sac and spinal cord has not significantly changed since the previous examination. Multiple lesions within the thoracic spine are otherwise unchanged, including the mild epidural tumor that mildly narrowing the spinal canal at the T9 level. There continues to be no definite abnormal signal within the spinal cord. The thoracic vertebral column alignment is unchanged. There appears to be right neck lymphadenopathy.
1. Slight increase in size of the posterior paraspinal fluid collection associated with the recent T4 decompression and residual epidural tumor extension at this level result in persistent spinal cord compression. 2. Diffuse osseous metastatic disease in the thoracic spine is otherwise unchanged. 3. Apparent right neck lymphadenopathy. Dedicated neck imaging may be useful for further characterization.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.