Clinical question: patient needs eval of spinal decompression s/p T8-12 fusion and T10 corpectomy, requires 1.5T scanner to minimize artifact. Signs and Symptoms: patient needs eval of spinal decompression s/p T8-12 fusion and T10 corpectomy, requires 1.5T scanner to minimize artifact. Nonenhanced thoracic MRI:Examination is a status post posterior approach multilevel laminectomy, T10 corpectomy and T8-T12 fusion and including bilateral transpedicular screw placement at T8, T9, T11 and T12 levels.The alignment of vertebral column remains anatomical.There is metallic hardware artifact which obscures the detail and results in distortion of images. Within this limitation however examination demonstrate no residual epidural mass at T10 level. There is extensive post operative changes of the posterior soft tissue of the thoracic spine without discrete fluid collection. There is expected very mild bulge/mass effect of post operative soft tissue changes at the level of laminectomy ( sagittal series images 10 through 12). There is mild uniform effacement of the subarachnoid space extending from T9 through T10 levels. At this level thoracic cord occupies the entire subarachnoid space and demonstrate internal increased T2/T2 STIR signal intensity which appears more conspicuous on current exam compared to prior study. This appearance is concerning for cord edema. The finding however could be at least partially secondary to artifact from metallic hardware. Extensive metallic signal intensity changes within the site of T10 corpectomy is noted. Heights at T10 level however is preserved and the alignment is anatomical.There is no evidence of spinal canal compromise at other levels of thoracic spine. Marrow signal changes consistent with metastatic lesions involving T5 vertebral body and small portion of T1 vertebral body remain similar to prior study.
1.Extensive postoperative changes of posterior laminectomy and multilevel fusion as detailed.2.Metallic hardware artifacts preclude precise assessment however there is no residual epidural tumor at the level of T10 corpectomy.3.There is mild uniform spinal canal compromise/effacement of subarachnoid space at T9 & T10 levels without detectable mass or postoperative collection.4.Increased T2 signal intensity/edema of thoracic cord at T8 toT11 which is more conspicuous on current exam. This change however could conceivably be at least partially secondary to suboptimal exam with extensive metallic hardware artifact. Correlation with neurological status is recommended.5.Stable foci of marrow signal replacement consistent with metastatic lesions similar to prior and without evidence of fracture, malalignment or spinal stenosis.