 Cervical spine:There is a slight anterolisthesis of C5 relative to C6. There are degenerative endplate signal changes at C6/C7. There is no definite pathologic marrow replacement in the cervical spine. There are no cervical cord signal abnormalities. There is no evidence of epidural tumor in the cervical spine. Note is made of a 1 cm left level three lymph node.C2/3: No significant canal or neural foraminal stenosis.C3/4: There is minimal uncovertebral and facet hypertrophy without canal or neural foraminal stenosis.C4/5: There are advanced facet hypertrophic changes, right greater than left, and disc-osteophyte formation with mild spinal canal stenosis and moderate bilateral neural foraminal stenosis.C5/6: There is advanced right facet hypertrophy and disc-osteophyte formation with moderate spinal canal stenosis with slight impingement of the spinal cord but without underlying cord signal abnormality. There is severe bilateral neural foraminal narrowing.C6/7: There is facet hypertrophy and disc-osteophyte formation contributing to mild spinal canal stenosis. There is moderate left and mild right neuroforaminal stenosis.C7/T1: There is no significant spinal canal or neuroforaminal stenosis.Thoracic spine:There are areas of marrow replacement involving many of the thoracic vertebral body levels. The most conspicuously affected vertebral body is T5 where there is some loss of height centrally and epidural expansion with encroachment of the spinal canal. The canal is narrowed, but the spinal cord is not significantly compressed as there is still intervening CSF. The left neural foramina of T5/T6 is also infiltrated with tumor.There is also significant involvement of the T11 vertebral body with loss of height anteriorly, but no significant retropulsion or obvious epidural tumor spread.Alignment is overall anatomic. The vertebral body heights are otherwise preserved. There is no thoracic spinal cord edema.
1. Metastatic disease involving many of the thoracic vertebral bodies. The T5 level is most severely affected where there is some osseous expansion and epidural spread resulting in spinal canal narrowing.2. No definite evidence of metastatic disease in the cervical spine. Degenerative changes as described above.