 There are postoperative changes of partial tumor resection involving the sacrum. There is a fluid density in the surgical bed. Tumor again seen approximating S2 and S3 nerve roots; however, it is better assessed on the pelvic studies. Surgical epidural drain is seen in place. There is heterogenous signal involving the spinal canal at S2-S4 levels related to the postoperative fluid. The lesions involving the bilateral iliac bones are partially visualized. There is normal alignment of the vertebral bodies. Vertebral body heights are maintained. The conus medullaris is seen in normal position at the level of L1. There is no evidence of spinal stenosis or neural foraminal compromise at any level in the lumbar spine.Expansile lytic lesion is noted involving the left 12th rib as seen on outside CT. Lesions involving the bilateral iliac bones also again seen.
Interval postsurgical changes of partial sacral tumor resection are seen. Tumor is again noted to abut the left S2 and S3 nerve roots and more completely assessed on the MRI pelvis study. Postoperative blood products are noted within the spinal canal at the S2 and S3 levels. Visualized lumbar spine is unremarkable.