 There is trace grade 1 retrolisthesis of C3 on C4 and C6 and C7, as well as anterolisthesis of C4 on C5. There is straightening of the normal cervical lordosis. The vertebral body heights are well-maintained. There is multilevel disc narrowing and desiccation, up to moderate-severe degree at C6-C7. Is a small focus of T1 hypointensity and T2/STIR hyperintensity with enhancement along the inferior endplate of C3 which may represent a small metastatic lesion. The spinal cord is of normal caliber and signal. There is no pathological enhancement.At C2-C3, there is no significant disk pathology or stenosis.At C3-C4, there is uncovering of the disc with a mild diffuse posterior osteophyte disk complex. There is also bilateral facet arthropathy and ligamentum flavum thickening resulting in overall mild to moderate central spinal canal stenosis and moderate left foraminal narrowing.At C4-C5, there is trace uncovering of the disc with mild-moderate right foraminal narrowing.At C5-C6, there is a mild diffuse posterior osteophyte disk complex with slight left paracentral prominence. There is significant bilateral uncovertebral hypertrophy resulting in moderate left and mild-moderate right foraminal narrowing. There is overall mild to moderate central spinal canal stenosis.At C6-C7, there is uncovering of the disc with mild diffuse posterior osteophyte disk complex resulting in up to moderate central spinal canal stenosis. Severe bilateral uncovertebral hypertrophy results in moderate right and moderate-severe left foraminal narrowing.At C7-T1, there is minimal central disc protrusion without stenosis.THORACIC SPINE
1.Diffuse osseous metastatic disease, with several levels of more confluent abnormality. One of these is noted at T10 where there is additional epidural spread of tumor resulting in moderate-severe central spinal canal stenosis, deformity of the cord, and abnormal cord signal suggestive of cord compression. Severe left and moderate-severe right foraminal narrowing at T10-T11.2.Scattered multilevel spondylotic changes as detailed above.Dr. Purakal discussed these findings over the telephone with Dr. Andrew Bokarius on 1/25/2016 20:20 hours.