Spinal metastatic disease. EMG with diffuse muscle denervation consistent with spinal disease. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is in the lumbar spine is benign without abnormal enhancement or suspicious lesions to suggest metastatic disease in the lumbar spine. No evidence of epidural tumor or abnormal leptomeningeal enhancement along the cauda equina. The conus medullaris is normal in position.Multilevel degenerative changes are again seen as seen on recent study from 9/29/2015 including moderate disc height loss at L5-S1. Individual levels as below:L1-2: No significant spinal canal or neuroforaminal stenosis. L2-3: Minimal bilateral foraminal disc bulging. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L3-4: Mild facet hypertrophy and ligamentum flavum thickening. Minimal bilateral foraminal disc bulge. No significant spinal canal stenosis. Mild to moderate right and mild left foraminal narrowing. L4-5: Severe right and moderate left facet hypertrophy. Mild ligamentum flavum thickening. Bulging disc with small superimposed left paracentral and right foraminal protrusions. Mild spinal canal narrowing involving the lateral aspects of the thecal sac. Moderate right foraminal narrowing. Minimal left neural foraminal narrowing.L5-S1: Moderate bilateral facet hypertrophy. Mild bulging disc. No significant spinal canal stenosis. Severe bilateral foraminal narrowing worse on the left and the right.Mild enhancement is seen in the posterior paraspinous soft tissues at the L3-L4 level which may be related to recent lumbar puncture. Known pelvic tumor recurrence better seen on recent CT.
1. No evidence of metastatic disease in the lumbar spine.2. Degenerative changes in the lumbar spine as above including severe bilateral L5-S1 neural foraminal stenosis and lesser degree of neural foraminal stenoses at right L3-L4 and L4-L5 levels. No high-grade spinal canal stenosis at any level.