History of multiple myeloma: lower extremity weakness. Cervical Spine: There is lack of the usual cervical lordosis. There are multilevel cervical posterior disc-osteophyte complexes, with associated mild indentation upon the spinal cord at C4-5. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. The spinal cord displays normal signal. The paravertebral soft tissues are unremarkable.Thoracic Spine: There is no significant interval change in the infiltrative tumor involving the right aspect of the T7 vertebra with epidural extension, but no spinal cord compression. The focus of enhancement in the posterior T4 vertebral body is less conspicuous. The thoracic spine alignment is anatomic and the vertebral body heights are preserved, aside from minimal anterior wedging of the T11 vertebral body. Lumbar Spine: There is a partially-imaged heterogeneous mass containing areas of probable necrosis within the right sacrum. There is considerable extension of tumor into the spinal canal at the S2 level. There is relatively high T1 signal in the vertebral bone marrow surrounding the tumor, which is likely attributable to prior radiation therapy. There is unchanged mild anterolisthesis of L4 on L5. There is multilevel lumbar degenerative spondylosis. In particular, there is moderate to severe right neural foraminal stenosis at L5-S1 due to a combination of tumor and the degenerative findings. Otherwise, there is no significant spinal canal stenosis in the lumbar spine and the lumbar vertebral body heights are preserved.
1. Partially-imaged mass involving the right sacrum, with considerable extension into the spinal canal at the S2 level. Please refer to the separate pelvis MRI report for additional details.2. No significant interval change in the infiltrative tumor involving the right aspect of the T7 vertebra with epidural extension, but no spinal cord compression.3. The focus of enhancement in the posterior T4 vertebral body is less conspicuous than in April 2015.4. Multilevel cervical posterior disc-osteophyte complexes, with associated mild indentation upon the spinal cord at C4-5. 5. Multilevel lumbar degenerative spondylosis, including moderate to severe right neural foraminal stenosis at L5-S1 due to a combination of tumor and the degenerative findings.