History of cervicothoracic laminectomy for metastases/debulking. Evaluate for changes/recurrence. Surveillance. Again seen are postoperative findings related to multilevel laminectomies in the lower cervical and upper thoracic spine. Vertebral body heights in the cervical spine are normal. Alignment of cervical spine is maintained. Mild degenerative changes are present including small disc osteophyte complexes at the C3-C4 to C5-C6 levels with ligamentum flavum thickening contributing to mild spinal canal stenosis. No high-grade spinal canal stenosis in the cervical spine. There is also fairly mild neural foraminal narrowing without high-grade neural foraminal stenosis at any level. Cervical cord signal is unremarkable.Again seen is severe compression fracture involving the T2 vertebral body (previously described as T1) with near complete loss of height and osseous retropulsion which is grossly similar to prior. Again noted is grade 2 anterolisthesis of T1 on T2 which appears similar to prior. There is resulting effacement of the ventral thecal sac and mild flattening of the ventral cord at the T2 level which is also similar to prior. Subtle T2 signal abnormality in the thoracic cord is again seen and extends into the left aspect of the cord to the T3-T4 level likely representing Wallerian degeneration along the left corticospinal tract. Posterior paraspinous enhancement in the laminectomy bed which is at least predominantly postsurgical is similar to prior without new or enlarging lesions to suggest tumor progression.Aside from T2, remaining thoracic vertebral body heights are maintained. Alignment is maintained. Focal signal abnormality involving the right T3 posterior elements is nonspecific but not significantly changed. Right T12-L1 lesion (previously described as T11-T12) demonstrates continued decrease in size compared to 5/24/2016 and 2/20/2016. No new metastatic lesions are appreciated. No evidence of epidural tumor. No cord signal abnormality involving the mid or lower thoracic cord. Spinal canal and neural foramina below the T2 level are also patent.
1. No evidence of progression of metastatic disease in the spine. 2. No significant change in severe compression fracture of the T2 vertebral body with osseous retropulsion and grade 2 anterolisthesis of T1 on T2. Associated indentation of the ventral cord at the T2 level is also not significantly changed. Subtle associated chronic cord signal abnormality involving the left aspect of the cord is also not significantly changed and may represent sequela of prior compression.3. Continued decrease in size of right T12-L1 lesion. Nonspecific focal signal abnormality involving the right T3 posterior elements which may represent treated lesion is not significantly changed. No new osseous lesion, new pathologic fracture, or epidural tumor.