Female, 84 years old, gait problems. The thoracic kyphosis is slightly exaggerated. Otherwise, sagittal alignment is within normal limits. Vertebral body heights are preserved. No evidence of marrow edema or marrow replacement is seen.Loss of disc height and disc bulging is evident at almost every level in the thoracic spine. At most levels, this results in mild to moderate spinal canal stenosis without significant cord deformation. At T8-9, however, disc bulging in combination with posterior element hypertrophy results in a moderate to severe stenosis with complete effacement of CSF and mild impingement of the spinal cord. The cord at this level demonstrates mild T2 hyperintensity. Elsewhere, no spinal cord signal abnormality is detected. No epidural collections are seen. The paraspinal soft tissues are within normal limits.The neural foramina are are narrowed on the right at T4-5 and bilaterally from T8-9 through T10-11. Perineural root sleeve cysts are noted incidentally in several of the foramina.
Degenerative disc disease is seen at almost every level in the thoracic spine with loss of disc height and disc bulging. At T8-9, disc bulging in combination with posterior element hypertrophy results in a moderate to severe spinal canal stenosis with mild impingement of the spinal cord. Subtle cord signal abnormally at this location could indicate either edema or myelomalacia. At most other levels, degenerative disease results in mild to moderate spinal canal stenosis without significant cord impingement.