Male, 55 years old, history of metastatic prostate cancer with pain and numbness in the lower pelvis and perineum. All the visualized osseous structures of the lumbar spine and sacrum demonstrate diffuse patchy abnormal marrow signal along with heterogeneous enhancement compatible with widespread osseous metastatic disease.Trace retrolisthesis of L2 relative to L3 and L3 relative to L4 are seen. The T11 vertebral body demonstrates mild central compression with approximately 40% loss of vertebral body height centrally. No retropulsion is seen. The remaining vertebral bodies demonstrate aspiration of height.No evidence of any significant epidural tumor encroachment is seen within the lumbar spine. In the sacral spine, however, there are several areas of nodular and plaque-like epidural thickening which involves the sacral spinal canal and some of the sacral foramina which result in significant narrowing and potential nerve root compression.Superimposed level specific degenerative findings are as follows:L1-2: Unremarkable. L2-3: Bulging disc. Mild generalized spinal canal narrowing. Mild bilateral foraminal narrowing. L3-4: Bulging disc. Minimal generalized spinal canal narrowing. Mild bilateral foraminal narrowing. L4-5: Mild facet hypertrophy. Mild bulging disc. No significant generalized spinal canal narrowing. Mild to moderate bilateral foraminal narrowing. L5-S1: Facet hypertrophy. Mild bulging disc. No significant generalized spinal canal narrowing. Moderate left and mild right foraminal narrowing.
1. Diffuse osseous metastatic disease.2. Relatively mild central compression deformity of T11 vertebral body without retropulsion.3. No definite or significant epidural disease spread in the lumbar spine.4. Plaque-like and nodular areas of epidural tumor are highly suspected within the sacral spinal canal and some of the sacral foramina. These lesions result in narrowing of the spinal canal and possible compression of adjacent nerve roots. These findings could potentially account for the patient's symptoms.