Female, 38 years old, with lower back pain. Assess for compression fracture or lytic lesions. For numbering purposes, the T12 vertebral body bears rudimentary ribs, while the L5 vertebral body shows a transitional morphology.A large region of marrow replacement is evident within the left aspect of the T12 vertebral body with a smaller region of marrow replacement in the right aspect of the L1 vertebral body. The pattern of this disease appears similar to that seen on a prior CT scan from March 2015. There may be some erosion of the superior endplate of L1, but no significant vertebral body compression is seen.Smaller marrow replacing lesions are evident on the left within the L4 vertebral body and L5 vertebral body. Again, these lesions appear similar to those seen on the prior CT, and no significant vertebral body compression is detected.Sagittal alignment of the spine is anatomic. The remaining vertebral bodies demonstrate normal morphology and signal characteristics.The spinal canal is patent throughout with no evidence of any significant epidural disease. The spinal cord, conus and cauda equina are unremarkable.At T12-L1, the right-sided L1 lesion results in very minimal bony expansion with slight effacement of the right ventral thecal sac. No significant spinal canal or neuroforaminal stenosis is detected.The remaining vertebral body levels are likewise free of significant spinal canal and neuroforaminal stenosis. No significant disc disease is evident.A marrow replacing lesion is partially visualized within the left iliac bone, also similar to that seen on prior CT.
1. Metastatic lesions are revisualized within the T12, L1, L4 and L5 vertebral bodies, as well as the left iliac bone. The size and morphology of these lesions appear similar to that noted on a prior CT exam from March 2015. No evidence of compression deformity or significant epidural disease extension is seen.2. The spinal canal remains patent throughout. At most, the lesion at L1 causes slight bony expansion which minimally effaces the right ventral thecal sac.3. No evidence to suggest any new vertebral body lesions is seen.