Male, 61 years old, with relapsed multiple myeloma. Evaluate for bony lesions. Cervical:Ill-defined nonspecific STIR hyperintensity is seen within the C6 vertebral body. Elsewhere within the cervical spine, marrow signal characteristics are somewhat heterogeneous which is felt to be degenerative in nature. No definite additional concerning marrow replacement is seen. The visualized spinal cord demonstrates normal signal characteristics. No epidural abnormalities are suspected.C2-3: Right facet hypertrophy. No significant spinal canal or foraminal stenosis. C3-4: Right facet hypertrophy. Mild posterior disc-osteophyte complex formation. Effacement of the ventral thecal sac with a mild generalized spinal canal stenosis. Mild bilateral foraminal narrowing. C4-5: Posterior disc-osteophyte complex formation resulting in effacement of the ventral thecal sac and slight flattening of the ventral cord. Mild to moderate generalized spinal canal stenosis. Severe bilateral foraminal narrowing. C5-6: Posterior disc-osteophyte complex formation resulting in slight effacement of the ventral thecal sac but no significant generalized spinal canal stenosis. Moderate left and severe right foraminal narrowing. C6-7: Mild posterior disc-osteophyte complex formation. No significant generalized spinal canal stenosis. Moderate right and mild left foraminal narrowing. C7-T1: Facet hypertrophy. Mild posterior disc-osteophyte complex formation. Mild bilateral foraminal narrowing. Thoracic:Hyperintensity and subtle T1 hypointensity is seen within the T2 and T4 vertebral bodies suspicious or pathologic marrow replacement. There may be scattered additional very small foci of T1 hypointensity within the vertebral bodies, but image resolution does not permit definitive diagnosis in this regard. Left lateral fusion instruments and strut grafts are noted spanning from T9 through L1, and artifact from these devices does obscure osseous evaluation to some degree. Despite this, it does appear that the left transverse process of T10 is expanded which probably reflects marrow space disease.Alignment is anatomic. Vertebral body heights are preserved. The visualized thoracic spinal cord shows no abnormal signal. No epidural abnormalities are suspected. Minimal scattered degenerative disc disease is seen without significant spinal canal or foraminal stenosis, though assessment of the foramina is somewhat limited in the instrumented region due to artifact.Lumbar:There are five lumbar type vertebral bodies with a transitional S1. Spinal alignment is anatomic. Vertebral body heights are preserved. Marrow signal characteristics are somewhat heterogeneous. Superimposed upon this, there are numerous very small foci of T1 hypointensity involving every lumbar level. Larger foci of marrow replacement on the order of 1 cm are seen within the left sacrum and the iliac wings.The distal spinal cord, conus and cauda equina demonstrate normal morphology. No epidural abnormalities are seen.Facet hypertrophy and ligamentum flavum thickening become progressively worse at lower lumbar levels. However, there is no significant disc bulging or disc herniation. The spinal canal remains patent throughout. Mild left neuroforaminal narrowing is seen at L5-S1.
1.Pathologic marrow signal is seen within the C6 vertebral body, the T2 and T4 vertebral bodies, the left T10 transverse process, and the sacrum and iliac bones highly suspicious for metastatic disease. There may be additional scattered very small foci of marrow replacement within the lumbar spine and elsewhere which could also indicate metastatic disease.2.Postoperative findings compatible with lateral instrumented fusion and partial corpectomy are seen spanning from T9 through L1. Elsewhere, vertebral body height and morphology are within normal limits. No compression deformities are identified. No epidural tumor is seen, and no tumor related spinal canal encroachment is detected.3.Degenerative disease is seen in the cervical spine with scattered spinal canal stenosis ranging from mild to moderate and scattered foraminal narrowing.