52-year-old male with urinary incontinence. Cervical spine: There is diffuse fatty marrow. There is minimal anterior wedging of the C5 vertebral body. Otherwise vertebral body heights are intact. There is multilevel disc desiccation with minimal disc space loss at C5-C6. There are posterior disc-osteophyte complexes at C4-C5, C5-C6 and C6-C7 without significant central canal or neural foraminal narrowing. There is absence of the usual cervical lordosis. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. There is diffuse fatty marrow. Thoracic spine: There is diffuse fatty marrow. There is compression deformity at T7 without increased STIR signal, which is unchanged. There are degenerative marrow signal characteristics along the superior endplate of T7 and inferior endplate of T6. There is a Schmorl's node within the inferior endplate of T9. The thoracic spine alignment is anatomic. There is apparent increased T2 signal within the cord from T7 to T10, which is likely artifactual. There is diffuse lipomatosis in the posterior epidural space that measures up to 7 mm in thickness. However, there is no significant central or neural foraminal stenosis. The paraspinal soft tissues are unremarkable.Lumbar spine: There is diffuse fatty marrow. There is a compression fracture of L2 which is unchanged from the CT of 10/7/2014 and without evidence of edema. There are endplate degenerative bone marrow signal changes at L1-L2 and along the superior endplate of L4. There is multilevel disc desiccation and vacuum disc phenomenon at L1-2. Alignment is anatomic. There is lipomatosis extending from L4-L5 inferiorly. Signal within the distal cord and conus is normal ending at L2. There is multilevel facet arthropathy. At L3-L4, there is a mild disc bulge, asymmetric to the left, but no significant spinal canal stenosis or neural foramen stenosis. At L4-L5, there is epidural lipomatosis associated with mild narrowing of the thecal sac, but no significant neural foramen stenosis. At L5-S1there is a mild diffuse disc bulge, facet hypertrophy with small effusions, and considerable epidural lipomatosis with severe spinal canal stenosis and mild right and moderate left neural foramen stenosis. There is also considerable epidural lipomatosis in the sacral canal with severe spinal canal narrowing. There is also pelvic lipomatosis.
1.Extensive thoracic, lumbar, and sacral epidural lipomatosis with severe lumbosacral spinal canal narrowing.2.Diffuse osteopenia that may be steroid-induced with chronic compression fracture deformities of the T7 and L2, and perhaps the C5 vertebrae, but no appreciable associated retropulsion.