 This exam is degraded by motion artifact. There is diffuse patchy replacement of the normal fatty marrow. There are numerous T2 hyperintense and enhancing osseous lesions throughout the spine, including the anterior and posterior elements as well as the posterior ribs, sacrum, and iliac bones, and clivus. Many of these lesions to demonstrate cortical disruption of the posterior vertebral body without significant epidural extension. However, at L3-L4 there appears to be slight epidural extension into the right neural foramen and at L5 and S1 there is mild epidural enhancement anterior to the thecal sac. The spinal cord displays normal signal and morphology. The vertebral body heights are preserved. These findings are superimposed on degenerative changes. For example, in the cervical spine, these changes are most prominent from C3 to C7 with multilevel disc osteophyte complexes that result in up to mild to moderate spinal canal stenosis as well as multilevel facet and uncovertebral joint arthropathy resulting in neural foraminal narrowing that is most severe on the right at C5-C6, and on the left at C6-C7. In the thoracic spine, there are mild multilevel degenerative changes including mild disc bulges, facet arthropathy, and ligamentum flavum thickening that do not result in significant spinal canal stenosis, but do result in moderate right neural foramen narrowing at T10-T11 and mild right neural foramen narrowing at T11-T12. There are degenerative changes that are more extensive in the lumbar spine, such as at L2-L3, a disc bulge and facet arthropathy contribute to moderate spinal canal stenosis. At L3-L4, a disc bulge, facet arthropathy, and ligamentum flavum thickening contribute to severe spinal canal stenosis and bilateral neural foramen stenosis. At L4-L5, a disc bulge with a superimposed right foraminal herniation results in right neural foramen narrowing and right subarticular zone narrowing. At L5-S1, there are severe endplate degenerative changes and loss of disc height, without significant spinal canal or neural foramen stenosis. The vertebral column alignment is within normal limits.
1.Extensive osseous metastatic disease to the axial skeleton with suspected areas of slight epidural extension in the lumbar spine most prominent at L5 and S1, but without associated significant spinal canal stenosis or loss of vertebral body heights.2.Degenerative spondylosis resulting in up to mild to moderate spinal canal stenosis in the cervical spine and up to severe spinal canal stenosis in the lumbar spine.