Evaluate for cord compression, history of kyphoplasty: sudden onset tingling, numbness, poor rectal tone. There is a metastasis within the T10 vertebral body associated with a pathologic fracture previously treated with kyphoplasty, as evidenced by cement that manifests sa low T1 and T2 signal. The tumor compresses the spinal cord, which appears to contain mild high T2 signal at the T10 level. The tumor also bulges into the paraspinal soft tissues at the T10 level and there is neural foraminal narrowing at the T9-10 and T10-11 levels bilaterally. There is a metastatic lesion that occupies much of the T5 vertebral body, where there is superior endplate concavity, but no retropulsion into the spinal canal. There is a subcentimeter T1 hypointense and T2 hyperintense lesion in the posterior T1 vertebral body. There is a hemangioma in the T6 vertebral body. There is advanced degenerative spondylosis at the L4-5 level, where there is disc space narrowing, fatty endplate marrow signal alterations, and disc bulge with superimposed eccentric left extrusion that results in severe bilateral neural foraminal stenosis, and mild spinal canal stenosis. There is also a focus of high T2 signal in the posterior L4 vertebral body more superiorly.
1. A metastasis arising from the T10 vertebral body associated with a pathologic fracture previously treated with kyphoplasty compresses the spinal cord. 2. A metastatic lesion that occupies much of the T5 vertebral body, where there is superior endplate concavity. 3. Probable small metastasis within the posterior T1 vertebral body.4. Advanced degenerative spondylosis at the L4-5 level with severe bilateral neural foramen stenosis and signal abnormality in the posterior L4 vertebral body that may be related to the degenerative process, although an underlying metastasis is not excluded.