Female, 72 years old, with metastatic breast cancer and back pain. Innumerable enhancing marrow space lesions are evident at every level of the visualized lumbosacral spine. Multiple lesions abut or slightly encroach upon the epidural space but without significant compromise of the spinal canal or neural foramina.The right lateral aspect of the L4 vertebral body is compressed with approximately 50% loss of height. Elsewhere, vertebral body heights are preserved allowing for scattered Schmorl's node deformities. Trace retrolisthesis of L5 relative to L4 and S1 is seen. Otherwise, spinal alignment is anatomic.The visualized distal spinal cord, conus and nerve roots of the cauda equina are normal in caliber and free of pathologic enhancement.L1-2: Facet arthropathy. Ligamentum flavum thickening. Minimal disc bulging. No significant spinal canal or foraminal stenosis. L2-3: Facet arthropathy. Ligamentum flavum thickening. Minimal disc bulging. No significant spinal canal or foraminal stenosis. L3-4: Facet arthropathy. Ligamentum flavum thickening. Mild disc bulging. Mild generalized spinal canal stenosis. Mild left foraminal narrowing. L4-5: Facet arthropathy. Ligamentum flavum thickening. Mild disc bulging. No significant spinal canal stenosis. Mild left foraminal narrowing. L5-S1: Facet arthropathy. Disc bulging and osteophytic ridging. Narrowing of the lateral recesses but no significant generalized spinal canal stenosis. Moderate bilateral foraminal narrowing.
Diffuse osseous metastatic disease is seen involving all levels of the visualized lumbosacral spine. Although a number of lesions abut and minimally encroach upon the epidural space, no significant tumor related spinal canal or foraminal compromise is identified. The right lateral aspect of the L4 vertebral body is compressed with approximately 50% loss of height.