60-year-old male with metastatic bladder cancer with acute back and RUQ pain with CT A/P showing L2 compression fracture. Further assess L2 compression fracture seen on CT. Note this is a limited examination due to patient motion and lack of postcontrast sequences.There is compression deformity of L2 anteriorly with approximately 50% loss of vertebral body height anteriorly. There is no retropulsion or evidence of epidural disease extension. There might be a discrete lesion within the L2 vertebral body on the left, however the marrow is diffusely abnormal in signal intensity likely a combination of edema and marrow infiltration by tumor. Posterior to L2 vertebral body there is what likely represents a tumor deposit along the posterior paraspinal soft tissues on the left. There is an additional tumor deposit centered on the posterior arch of L3 vertebral body involving the laminae, spinous process and facet complexes with associated epidural extension posteriorly resulting in narrowing of the spinal canal and crowding of the cauda equina.The spinal cord itself is normal in signal intensity with no evidence of cord compression. There is facet arthropathy throughout the lumbar spine. Most levels show some degree of degenerative disk disease, most pronounced at L5-S1. No high grade stenosis is seen secondary to the degenerative findings. There is fairly significant retroperitoneal adenopathy as well as a cystic lesion in the left kidney.
Limited examination due to patient motion and lack of postcontrast sequences.1. Pathologic compression fracture of L2 vertebral body without retropulsion or epidural disease extension. 2. Tumor deposit centered along the posterior arch of L3 does result in epidural extension, spinal canal narrowing and crowding of the cauda equina.3. Additional tumor deposit along the posterior paraspinal soft tissues at L2 is noted. 