 There is no conclusive acute cord compression.There is abnormally low T1 and high T2 signal throughout multiple vertebrae and the sacrum compatible with metastatic disease. These findings are most extensive in the lower thoracic and upper lumbar spine vertebral bodies. The entire T12 and L1 vertebral bodies are involved and there is mild loss of height at L1 with dorsal convexity of the posterior cortex, which deforms the thecal sac resulting in moderate spinal canal narrowing. As seen on the prior MRI of the lumbar spine, the conus terminates at the L1-2 level. There is a decrease in caliber of the distal cord and conus with minimal high T2 signal which likely represents myelomalacia although given the adjacent bulging vertebral body cortex, some areas of recent mass effect cannot be excluded. CSF is seen surrounding the cord at this level.There is mild anterior wedge deformity of T5, deformity of both endplates of the T9 vertebral body as well as moderate deformities of the L2, 3 and 5 vertebral bodies with associated edema involving the adjacent discs and marrow.There is developmental narrowing of the entire cervical and mid to distal lumbar spine which, combined with degenerative disc disease, leads to spinal canal narrowing that is moderate to severe in the mid cervical spine and mild to moderate in the mid to lower lumbar spine. There is no abnormal cord signal at these levels.
1.No conclusive acute cord compression. Dedicated segment-specific MRI is recommended if symptomology localizes and/or if subsequent therapies are required for areas which have not had previous dedicated imaging.2.Diffuse vertebral and left sacral metastases with pathologic compression fractures at T5, T9, L1, L2 , L3 and L5. Convexity of the posterior aspect of the L1 vertebral body deforms thecal sac and results in moderate narrowing of the spinal canal. Decreased caliber and mild increased signal of the distal cord and conus at this level is most likely due to myelomalacia although superimposed recent mass effect on the cord cannot be entirely excluded.3.Developmental narrowing of the cervical and mid to distal lumbar spine with superimposed multilevel degenerative changes results in progressive spinal canal narrowing which is moderate to severe in the cervical spine and mild to moderate in the mid to lower lumbar spine.