 Please note examination is significantly motion degraded as patient could not tolerate the study. Post gadolinium images were obtained of the thoracic spine. Post contrast images of the cervical spine could not be obtained.As seen on recent lumbar spine MRI from 8/1/2016 there is a fluid collection involving the ventral epidural space extending superiorly from the lumbar spine. Current cervical and thoracic MRI images demonstrate large fluid collection which extends throughout the cervical and thoracic spine. Mild peripheral enhancement is evident on the thoracic study. The collection extends superiorly to the C1 level. The cervical and thoracic cord are posteriorly displaced and there is impression on the ventral aspects of the cervical and thoracic cords. Fluid collection predominantly involves the right ventral aspect of the upper thoracic spinal canal and the bilateral ventral epidural space in the lower thoracic as well as the cervical spine. Small loculations are evident in the upper cervical spine.No obvious cord signal abnormality within the limits of the study. Minimal degenerative changes are evident in the cervical and thoracic spine.There is deformity involving the superior T12 endplate with mild height loss and prominent Schmorl's node. Vertebral body heights in the cervical and thoracic spine are grossly maintained. No obvious destructive osseous lesions. No findings to suggest discitis-osteomyelitis in the cervical or thoracic spine based on the limited sequences.
Large ventral epidural fluid collection with peripheral enhancement which tracks superiorly from the lumbar spine and involves the entire thoracic as well as the cervical spine to the C1 level. There is at least moderate degree of diffuse cervical and thoracic spinal canal stenosis and mild flattening of the spinal cord. Given the extent of the epidural collection as well as a paraspinous collection, this may have originated as a pseudomeningocele/CSF leak, now with suspected superimposed infection/epidural abscess formation.