Breast cancer with diffuse bony metastasis, declining function and ability to walk. Left lower extremity weakness. There is diffuse osseous metastatic disease throughout the cervical, thoracic, and lumbar spine involving the anterior and posterior elements. Vertebral body heights are maintained. There is most likely epidural tumor at the L4 level dorsal to the vertebral body measuring up to 1 cm in thickness and is associated with mild spinal canal stenosis. There is otherwise no high-grade spinal canal stenosis in the cervical, thoracic, or lumbar spine. No evidence of acute cord compression or cauda equina compression. Alignment is maintained. No gross cord signal abnormality is evident. Mild degenerative changes are also evident including multilevel small disc osteophyte complexes and ligamentum flavum thickening in the cervical spine, but again without high-grade spinal canal stenosis.
1. Numerous osseous metastatic lesions throughout the spine without evidence of acute cord compression or cauda equina compression.2. Epidural tumor at the L4 level without high-grade spinal canal stenosis.3. This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.