Clinical question: Status post tumor resection. Signs and symptoms: Bilateral nor extremity numbness. Pre-and post-enhanced thoracic MRI:Examination is to status post laminectomy at T9, T10 and T11 levels for removal of tumor. There is interval complete removal of posterior epidural tumor at these levels with resultant expansion of thecal sac and significantly better visualization of the cord. There is a slight increased cord caliber at T9 level compared to T10 and with very subtle suggestion of increased T2 signal intensity suspicious for presence of edema at this level.T9 level demonstrate diffuse marrow signal abnormality all vertebral body consistent with tumor which demonstrate mild bilateral ventral epidural spread with subtle mass-effect and posterior displacement of the cord (axial T2 series 1002 image 25) however without central spinal stenosis. Tumor within the right neural foramina at this level is again noted as similar to preoperative studies. Multiple additional foci of osseous metastatic lesions demonstrate no significant change since prior exam.There is a surgical drain in the posterior epidural space at the surgical site extending from the T9 level inferiorly and exiting the epidural space posteriorly at T11 -- T12 disk level.There is no evidence of mass effect on the thecal sac secondary to postoperative changes of laminectomy posteriorly.
1.Complete removal of posterior epidural tumor at T9 through T11 via posterior multi-level laminectomy as detailed.2.There is slight thickening of the thoracic cord at T9 compared to adjacent levels with subtle increased T2 signal suggestive of subtle edema.3.There is no evidence of spinal stenosis at any level.4.There are shallow bilateral ventral epidural spread of tumor at T9 level with subtle mass effect on the cord however without central spinal stenosis.5.Multiple additional levels of osseous metastatic lesions demonstrate no evidence of change.