Male, 71 years old, with pain in the L5-S1 intervertebral distribution on the right. History of advanced non-small cell lung cancer with bone metastases. Since the prior examination, significant progression is seen in the size and number of numerous marrow replacing, enhancing lesions compatible with osseous metastatic disease. Small lesions are evident within every vertebral body level. In addition, there are large dominant lesions involving the L3 vertebral body, the S1 and S2 vertebral bodies, and the left iliac bone.Slight endplate concavity is evident at L3. However, no significant compression deformity is seen. Vertebral body heights are generally preserved.No evidence of significant epidural tumor extension is seen. The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No pathologic intrathecal enhancement is seen.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Mild disc bulging asymmetric to the left. The left lateral recess is mildly effaced. No significant generalized spinal canal stenosis. Mild left foraminal narrowing. No interval changes. L3-4: Facet arthropathy. Bulging disc. Mild generalized spinal canal narrowing. Mild bilateral foraminal narrowing. No interval changes. L4-5: Facet arthropathy. Bulging disc. Mild generalized spinal canal narrowing. Moderate left and mild right foraminal narrowing. No interval changes. L5-S1: Facet arthropathy. Bulging disc. No significant spinal canal stenosis. No significant foraminal narrowing. No interval changes.
1.Progression of osseous metastatic disease is seen at all vertebral body levels including the sacrum and iliac bones.2.No compression deformities are seen. No significant epidural tumor involvement is detected.3.Multilevel degenerative findings show no significant change from the prior examination.