Male, 67 years old, with prostate cancer, and abnormal balance, concern for cord compression. Cervical:The marrow spaces are diffusely heterogeneous compatible with widespread osseous metastatic disease. Vertebral body heights are preserved. The normal cervical lordosis is slightly reversed along with a very mild scoliotic curvature.The visualized spinal cord demonstrates normal signal intensity and morphology except as discussed by level below. No epidural abnormalities are suspected.C2-3: Posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Moderate left and mild right foraminal narrowing. C3-4: Facet hypertrophy. Posterior disc-osteophyte complex formation asymmetric to the left paracentral and foraminal zones. The disc osteophyte effaces the left ventral thecal sac and just contacts the cord with slight cord flattening but no evidence of cord compression or significant spinal canal stenosis. Severe left and moderate right foraminal narrowing. C4-5: Facet hypertrophy left more than right. Uncovertebral hypertrophy. No significant spinal canal stenosis. Moderate bilateral foraminal narrowing. C5-6: Facet hypertrophy left more than right. Uncovertebral hypertrophy. No significant spinal canal stenosis. Moderate bilateral foraminal narrowing. C6-7: Facet hypertrophy left more than right. Posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Severe right and mild left foraminal narrowing C7-T1: Facet hypertrophy. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. Thoracic:Diffuse marrow heterogeneity is again seen compatible with widespread osseous metastatic disease. Vertebral body heights are preserved. There is a mild scoliotic curvature of the thoracic spine. Sagittal alignment is within normal limits.Beginning at the T8 level and continuing down to the T10 level, the left lateral epidural space is encroached upon by soft tissue. This is most severe at the T8-9 level where the spinal cord is displaced right laterally and mildly compressed. There is complete effacement of CSF and a significant generalized stenosis at this level. No definite cord signal abnormality is seen.At the T11 level, there may be mild soft tissue encroachment upon the lateral and right dorsal epidural spaces. However, this causes no significant spinal canal stenosis or cord compression.Scattered disc bulges and/or disc protrusions are seen at multiple levels, some of which contact and/or mildly deform the cord such as at T3-4. These, however, cause no significant generalized spinal canal stenosis. The left-sided neural foramina at T8-9 and T9-10 are infiltrated and narrowed by epidural tumor as above. The foramina are otherwise unremarkable.Multiple tumor deposits are seen along the posterior thoracic wall of the left lung apex.
1.Significant epidural tumor encroaching upon the left lateral spinal canal from T8 through T10. The lesion is most severe at the T8-9 level where there is displacement of the spinal cord to the right and mild cord compression but no definite evidence of cord edema.2.There may be a few additional small areas of epidural tumor as above, but these cause no significant spinal canal stenosis and no evidence of cord compression.3.No evidence of cord compression is seen in the cervical spine.4.Multilevel degenerative findings as discussed above.