incontinent bowel/bladder, decreased leg strength, prior mri from osh reviewed by neurosurgery. Evaluate for hematoma vs lymphoma. Thoracic spine:There are multilevel degenerative changes throughout the thoracic spine without evidence of high-grade central canal stenosis. The thoracic spine is in normal alignment. No worrisome focal marrow signal abnormality is appreciated. Within the limits of a motion degraded exam, there is no obvious cord signal abnormality.Mild disc bulges are noted at the T2-3, T5-6, T6-7, T7-8, T8-9, and T9-10 levels but there is no significant compromise to spinal canal or neural foramina.At the T10-11 level there is a mild disc bulge, facet arthropathy and ligamentum flavum thickening as well as minimal retrolisthesis of T10 and T11 which causes mild central canal stenosis and moderate to severe left neuroforaminal stenosis. No significant right neural foraminal stenosis.At the T11-12 level there is loss of disc height and a 14 mm of superior extrusion of disc material. There is minimal arthrosis at this level but no significant compromise to spinal canal or neural foramina. Lumbar Spine:There is mild exaggerated lordosis and grade 1 anterolisthesis of L3 on L4 and L4 on L5. There is some loss of disc height at the L3-4 and L4-5 levels. The vertebral body heights are preserved. The vertebral bone marrow signal is heterogeneous which is nonspecific. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. T12-L1: There is no significant compromise to spinal canal or neural foramina.L1-L2: There is mild facet arthropathy but no significant compromise to spinal canal or neural foramina.L2-L3: There is mild facet arthropathy but no significant compromise to spinal canal or neural foramina.L3-L4: There is anterolisthesis of L3 on L4 which causes uncovering of the disc, a superimposed disc bulge and advanced facet arthropathy which cause moderate to severe central canal stenosis. A 9 x 7 x 15 cm low T1/high T2 ovoid structure extending from the L3-4 level to the mid L4 level within the posterior spinal canal, likely represents a synovial cyst and this along with prominent posterior epidural fat contributes to the moderate to severe stenosis at this level. This is best seen on sagittal STIR images series 23, image 11. There is also moderate to severe right and moderate left neuroforaminal stenosis.L4-5: There is anterolisthesis of L4 on L5 with advanced facet arthropathy and prominence of the posterior epidural fat which causes moderate to severe central canal stenosis. There is also moderate right and moderate to severe left neuroforaminal stenosis.L5-S1: There is no significant compromise to spinal canal or neural foramina.A large T2 hyperintense cystic structure is noted involving the left renal pelvis and most likely represents a parapelvic cyst.
Thoracic spine:1.Multilevel degenerative changes without evidence of high-grade central canal stenosis.2.No evidence of an epidural hematoma or neoplasm.3.Within the limits of a motion degraded exam, there is no obvious cord signal abnormality.Lumbar spine: 1.Advanced degenerative changes with moderate to severe central canal stenosis at L3-4 and L4-5 with neural foraminal stenosis as detailed above.2.Cystic structure dorsal to the thecal sac at the L4 level likely represents a synovial cyst, which contributes to the moderate to severe central canal stenosis at this level.