Status post fall. Low back pain radiating to both legs. Lytic lesions are seen throughout the lumbosacral spine, from T12 to the sacrum, correlating with the enhancing lesions seen on the prior MRI study. There is involvement of the anterior and posterior elements. There is involvement of the distal sacrum. There are small pathological fractures at the left pedicle and transverse process of T12, at the inferior endplate of L5 and superior endplate of S1, with minimal displacement of small fracture fragments. There is scoliosis in the lumbar spine, but the alignment of the lumbosacral spine is essentially maintained. There is lesion extending into the right sacroiliac joint. There are lesions involving the iliac bones bilaterally.
Diffuse metastatic disease involving the thoracolumbar junction, throughout the lumbar spine, sacrum, and iliac bones bilaterally. There are small minimally displaced pathological fractures as described. 