Low back pain [M54.5], Reason for Study: ^Reason: assess for stenosis History: BL LE weakness (proximal worse than distal, R > L) and suppressed reflexes at right knee and ankle. History of prostate cancer. Thoracic MRI:Postoperative (colpectomy and external fixation) between T10-L1 and kyphoplasty at L2.Multiple metastatic lesions on cervical, thoracic and lumbar vertebral bodies as well as ribs. The extent of involvement appears to be unchanged since Dec 1 2015 but progressed since Mar 26 2015.Multifocal various degreed height loss (compression fractures) of thoracic vertebral bodies are again seen, no change since Dec 1 2015.Thoracic spinal cord signal intensity is normal.Lumbar spine:Redemonstration of multiple metastatic lesions on lumbar vertebral bodies, sacrum and bilateral ilium, no change since prior scan.Previously noted undulating shape epidural lesion appears to be stable in size and configuration.Spinal cord signal intensity appears to be normal.The conus medullaris terminates at the L1 level. Degenerative changes are specified by the intervertebral level as follows: T12-L1: external fixation using screw is seen, no neuroforaminal narrowing or spinal stenosis. L1-L2: about 20-30% height reduction with bone cement within the vertebral body indicating post kyphoplasty status, no neuroforaminal narrowing or spinal stenosis. About 2 mm thickness intrathecal lesion on the right posterolateral aspect of the thecal sac.L2-L3: about 3mm thickness intrathecal lesion on the left posterolateral aspect of the thecal sac with subtle mass effect toward spinal cord. No neuroforaminal narrowing or spinal stenosis. L3-L4: diffuse bulging of disc with bilateral ligamentum flavum thickening result mild spinal canal stenosis, there is about 2mm thickness intrathecal lesion midline posterior aspect of the thecal sac. No neuroforaminal narrowing or spinal stenosis. L4-L5: diffuse bulging of disc with central broad based disc protrusion result moderate to severe spinal canal stenosis, no neuroforaminal narrowing or spinal stenosis. L5-S1: there is curvilinear intrathecal lesion on the right posterolateral aspect of the thecal sac with mild mass effects toward spinal cord, no neuroforaminal narrowing or spinal stenosis.
1. No change of multifocal metastatic lesions on thoracic spine, lumbar spine, ribs, sacrum and bilateral ilium.2. Intra thecal fluid collecting lesions likely represent subdural space along lumbar spine with various degree mass effects toward spinal cord as described above, no change in extent, size and configuration since prior scan.3. Degenerative changes of lumbar spine especially at the level of L45, there is moderate to severe spinal canal stenosis.