Female, 77 years old. Reason: CT showed cord compression History: Ataxia THORACIC SPINE:The thoracic vertebral bodies are appropriate in the overall alignment and height. Disc space heights are preserved.There multiple osseous metastatic lesions involving the thoracic spine, including vertebral body metastases at T1, T3, T7, and T12, with additional scattered punctate areas of enhancement throughout the vertebral bodies which likely reflect metastatic foci.A large expansile metastasis centered on the left T9 pedicle appears increased from the prior CT exam dated 07/13/2015, measuring 2.7 x 2.4 cm, extending into the epidural space with associated moderate to severe spinal canal stenosis and rightward cord displacement. There is no focal intrinsic cord signal abnormality at this level. This lesion also encroaches on the left T8-9 foramen with associated marked narrowing.There are additional scattered metastatic lesions involving the posterior elements and posterior ribs throughout the thoracic spine, including an approximately 2 cm lesion involving the right eighth costovertebral joint and an approximately 1.5 cm lesion involving the left seventh costovertebral joint, with associated neuroforaminal narrowing at these levels.There is no intrinsic cord signal abnormality elsewhere in the thoracic spine to suggest acute cord compression.CORD COMPRESSION:Examination of the remainder of the spine is limited to the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. The vertebral bodies are appropriate in the overall alignment and height. At the cervical and lumbar levels, the spinal cord has normal signal characteristics and overall morphology. There is no compromise of the spinal cord at these levels.The above described metastatic lesions in the thoracic spine are redemonstrated, with additional vertebral body metastases identified in the cervical and lumbar spine, including a large L3 metastasis. There is no significant central canal stenosis at the cervical and lumbar levels.
1. Multiple metastatic lesions involving the vertebral bodies and posterior elements of the thoracic spine, including a large left T9 pedicle metastasis with moderate to severe associated canal stenosis and cord displacement but no associated cord signal abnormalities. No additional areas of significant spinal canal stenosis are suspected.2. No evidence of acute cord compression at the cervical and lumbar levels on the provided screening examination.