Findings:
Scattered vertebral lesions are seen throughout the spine. Complete destruction and bone marrow oedema is seen at C2 and C3 vertebrae, which have been replaced by T1-hypointense metastatic tissue, extending to the prevertebral soft tissue and encasing the vertebral arteries bilaterally.
No displacement. Prevertebral fluid is seen extending from craniocervical junction to C5 level, measuring up to 1.1 cm in depth.
No further pathological fracture.
Disc bulging and bilateral osteoarthritis of the facet joints is seen at C3/4 with moderate to high-grade central canal stenosis and high-grade bilateral neural exit foraminal stenosis. No obvious myelopathy.
High-grade bilateral neural exit foraminal stenosis is also seen at C4/5 – C6/7.
No pathological fracture is identified in the thoracic or lumbar spine.
Grade 1 degenerative anterolisthesis is seen at L4/5 with consequential pseudo-disc and bilateral osteoarthritis of the facet joints. Additional right paracentral disc protrusion with right-sided lateral recess stenosis at this level.
Left paracentral disc protrusion is also seen at L5/S1, affecting the descending S1 nerve root on the left side.
No further stenosis was noted.
Conclusion:
Disseminated vertebral metastases.
Complete destruction and pathological fracture of C2 and C3 vertebral bodies without displacement. Metastatic tissue extending to the paravertebral soft tissue at C2/3 levels, encasing the vertebral arteries bilaterally.
No further pathological fracture.
Degenerative moderate to high-grade central canal stenosis at C3/4 as well as high-grade bilateral neural exit foraminal stenosis at C3/4 – C6/7. No obvious myelopathy.
Disc protrusions with stenosis of the lateral recesses at L4/5 on the right side and at L5/S1 on the left side.