History of bladder cancer with metastasis to L2 and trauma presents with pain. The vertebral bodies are appropriate in the overall alignment and height. The spinal cord has grossly normal signal characteristics and overall morphology. There is no frank cord compression or high-grade spinal canal stenosis. There is reversal of cervical lordosis with moderate degenerative changes in the cervical spine including multilevel disc desiccation and loss of disc height at several levels. No evidence of high-grade spinal canal stenosis in the cervical or thoracic region.There is kyphotic angulation centered at L2 with retrolisthesis of L2 over L3. There is degenerative changes with endplate irregularity and marrow signal changes involving the L2 and L3 vertebral bodies. There is severe loss of L2-L3 disc space. In addition there is T1 hypointense lesion along the posterior superior aspect of L2 vertebral body with soft tissue extending to the ventral epidural space., There is mild to moderate spinal canal stenosis at this level.Again seen partially visualized bladder tumor and bladder diverticula, better seen on prior CT dated 3/16/2016.
1. This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No frank cord compression is identified. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.2. Likely metastatic lesion involving the posterior superior L2 vertebral body with suggestion of mild epidural extension. There is mild to moderate spinal canal stenosis suspected at this level. Suggest dedicated lumbar spine MRI with gadolinium for further evaluation.3. Partially imaged known bladder carcinoma and bladder diverticula, better seen on prior cross-sectional imaging.4. Degenerative changes in the cervical and lumbar spine without high-grade spinal canal stenosis.