Clinical question: Status post metastatic spinal cord tumor resection. Signs and symptoms: Status post metastatic spinal cord tumor resection. Pre-and post-enhanced thoracic MRI:Examination demonstrate interval posterior laminectomy as well removal of the spinous processes for tumor resection at T8 and T9 levels. There are also post operative changes of posterior spinal fusion with placement of bilateral transpedicular screws at T7 and T10 levels. Postoperative changes at the levels of T8 laminectomy demonstrate mass effect on the thecal sac posteriorly and with effacement of subarachnoid space and displacement of the cord anteriorly. The signal intensity of the thoracic cord called to remains reading normal which can be assessed only on sagittal series. Axial images through the surgical sites are suboptimal due to excessive artifact from metallic hardware.Marrow signal replacement of the vertebral bodies of T7 T8 and T9 and including the left pedicle of T8 and T9 representing metastatic disease is again noted without convincing evidence of change. A focus of marrow signal replacement in the body of T7 vertebrae consistent with a metastatic disease demonstrating slight interval increased size.There is no detectable abnormal enhancement of the cord or the meninges.
1.Interval laminectomy and removal of the spinous processes of T8 and T9 for removal of tumor. Postoperative changes posteriorly results in mass effect on the thecal sac and with forward displacement of cord and effacement of subarachnoid space at T8 level.2.Interval fusion and placement of fixating transpedicular screws bilaterally at T7 and T10.3.Marrow signal changes of vertebral bodies and including the left pedicles at T8, T9 and T10 levels are again noted and are presenting tumor without change.4.Focus of metastatic lesion in the vertebral body of T11 which demonstrates minimal interval increased size.5.Normal signal intensity of the cord and without abnormal enhancement.