70-year-old male with history of epidural lipomatosis, status post T6-T9 laminectomies with posterior spinal fixation at T6-T10. There has been recent T6-T10 posterior fusion. The surgical hardware causes artifact that obscures the spinal canal at these levels. There is also underlying diffuse epidural lipomatosis that contributes to spinal canal narrowing, with near complete effacement of the thecal sac cerebrospinal fluid superior and inferior to the operated levels. In addition, there are multiple prominent anterior thoracic disc-osteophyte complexes. There are postoperative findings related to multilevel anterior fusion from C3 to C6. There are disc-osteophytes at C6-C7, T1-2, and T2-3, where in conjunction with epidural lipomatosis and ligamentum flavum thickening, there is mild indentation of the spinal cord, which appears to display mild T2 hyperintensity. Enhancement within the inferior right aspect of the T1 vertebral body is likely degenerative in nature. The thoracic vertebral column alignment is near anatomic and the vertebral body heights are essentially intact. There are small bilateral pleural effusions.
1. Postoperative findings related to recent midthoracic laminectomy and fusion, although surgical hardware artifact limits assessment of this region.2. Diffuse narrowing of the spinal canal superior and inferior to the operated levels due to extensive epidural lipomatosis. In addition, disc-osteophytes at C6-C7, T1-2, and T2-3, which in conjunction with the epidural lipomatosis and ligamentum flavum thickening result in mild indentation of the spinal cord with associated myelomalacia. 3. Multiple prominent anterior thoracic disc-osteophyte complexes are likely related to degenerative spondylosis. 4. Small bilateral pleural effusions.