Female, 54 years old, with history of longitudinally extensive cervical transverse myelitis presenting with new weakness and pain. Cervical:Volume loss of the mid cervical spinal cord is seen along with patchy central cord T2 hyperintensity most conspicuous between C2-3 and C4-5. No pathologic intramedullary or leptomeningeal enhancement is seen. No areas of cord edema are detected on this examination.Straightening of the cervical lordosis is demonstrated. Sagittal alignment is otherwise unremarkable. Vertebral body height and morphology are within normal limits. Marrow signal characteristics are within normal limits.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: Left greater than right facet hypertrophy. Posterior disc-osteophyte complex formation. Effacement of the ventral thecal sac with slight flattening of the right ventral cord. No significant generalized spinal canal stenosis. Moderate left foraminal narrowing. C4-5: Left greater than right facet hypertrophy. Posterior disc-osteophyte complex formation with left paracentral/foraminal focality. Effacement of the ventral thecal sac with flattening of the left ventral cord. No significant generalized spinal canal stenosis. Mild left foraminal narrowing. C5-6: Facet hypertrophy. Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. Mild left foraminal narrowing.C6-7: Facet hypertrophy. No significant spinal canal stenosis. Mild left foraminal narrowing. C7-T1: Facet hypertrophy. No significant spinal canal stenosis. Mild left foraminal narrowing. Thoracic:The spinal cord is free of signal abnormality. No evidence of intramedullary or leptomeningeal enhancement is seen.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. Marrow signal characteristics are unremarkable.Facet arthropathy is demonstrated at T5-6. A small left paracentral disc protrusion is seen at T6-7. Facet arthropathy and ligamentum flavum thickening are demonstrated on the right at T10-11. No areas of significant spinal canal or foraminal stenosis are identified.
1.Evidence of myelomalacia is seen in the mid cervical spinal cord which would correlate with the history of prior transverse myelitis.2.No evidence of cord edema or pathologic cord or leptomeningeal enhancement is seen in either the cervical or thoracic regions to suggest active inflammation.3.Scattered cervical spondylosis is demonstrated. Although no significant generalized spinal canal stenosis is seen, disc osteophytes do contact the spinal cord at several levels as above.4.Minimal spondylosis is seen in the thoracic spine without evidence of cord impingement or significant stenosis of the spinal canal or neural foramina.