Bilateral lower extremity weakness and sensory level There are postsurgical changes related to anterior corpectomy of C5 and anterior fusion of from C4 to C6. There is moderate spinal canal stenosis from the C4-C5 and C5-C6 levels which appears mildly worse since 1/5/2016. Finding may be related to worsening epidural tumor and can be better assessed with dedicated cervical spine study with gadolinium.There is a severe compression fracture at the T5 level which appears worse with associated osseous retropulsion and epidural tumor resulting in deformity of the cord. This finding appears slightly worse compared to 1/5/2016. Tumor infiltration involving the T6 and T8 vertebral bodies again seen. There appears to be increased tumor infiltrating the T8 vertebral body compared to prior with mild pathologic compression fracture but without spinal canal stenosis. No significant spinal canal stenosis in the lower thoracic or lumbar spine is appreciated.
Evidence of osseous metastatic disease in the spine is again seen. There is mild further worsening of moderate to severe spinal canal stenosis and cord deformity at the T5 level and to a slightly lesser degree at the C4-C5 to C5-C6 levels. There is also worsened compression fracture at the T5 level. Please note this examination was performed per screening cord compression protocol and would recommend dedicated cervical and thoracic spine MRI studies with gadolinium for further evaluation.