Male, 68 years old, with history of prostate cancer and worsening lower extremity weakness. Widespread osseous metastatic disease is seen through the entire spine, progressed from prior MRIs. No acute cord compression is seen and there is no evidence to suggest any significant spinal canal narrowing in the cervical or thoracic regions. Several of the upper thoracic vertebral bodies show loss of height on the order of 30% when compared to a prior CT examination from 3/26/2015. Postoperative findings are again seen at T10-L1 compatible with corpectomy and lateral fusion. Kyphoplasty of L2 is also seen. The L2 vertebral body is compressed with up to 60% loss of vertebral body height, similar to prior. As on the prior examination, there is an undulating prominently dorsal epidural fluid collection in the lumbar region which causes a significant spinal canal narrowing, particularly at lower lumbar levels, and likely some crowding and/or compression of the cauda equina nerve roots. It is difficult to determine on this limited examination whether the degree of spinal canal narrowing has progressed from prior.
1.Progression of widespread osseous metastatic disease.2.No definite evidence of cord compression or significant spinal canal narrowing in the cervical and thoracic regions.3.Postoperative findings are redemonstrated at the thoracolumbar junction.4.Redemonstration of an undulating epidural collection involving much of the lower thoracic spine which results in significant spinal canal narrowing and likely crowding and/or compression of the cauda equina. It is difficult to determine on this limited examination if the degree of spinal canal narrowing has progressed from prior. Dedicated lumbar imaging would be helpful in this regard.