Male, 27 years old, with lower extremity weakness and apparent sensory level. Thoracic:The thoracic kyphosis is mildly exaggerated. Sagittal alignment is otherwise unremarkable. Mild loss of vertebral body height is seen at T3 with edema and enhancement in the superior aspect of the vertebral body. No retropulsion is observed. A Schmorl's node deformity is evident superiorly at T5. No other areas of abnormal marrow replacement or enhancement are seen. Dorsal epidural lipomatosis is seen causing complete CSF effacement from T2 down to T9. No definite spinal cord signal abnormality or pathologic cord enhancement is demonstrated.Lumbar:Alignment is anatomic. Vertebral body heights are maintained. Small Schmorl's node deformities are evident at L2, L3 and L4. No areas of pathologic marrow replacement or enhancement are seen. Dorsal and ventral epidural lipomatosis is evident in the lower lumbar spine. This results in effacement of CSF and crowding of the cauda equina beginning at the L3 level and continuing into the sacrum. The distal spinal cord, conus and nerve roots of the cauda equina show normal signal and are free of pathologic enhancement. Mild edema is seen within the posterior paraspinal muscles.
1.A mild compression deformity of the T3 vertebral body is seen. The presence of edema and enhancement would suggest a relatively more recent time course. No associated retropulsion or osseous compromise of the spinal canal is seen.2.No other significant or acute osseous abnormalities are identified.3.Epidural lipomatosis is seen in the thoracic and lumbar spine. In both areas, this results in effacement of the CSF and, in the lumbar spine, crowding of the cauda equina.