Diagnosis: Unspecified cord compressionClinical question: cause of motor weaknessSigns and Symptoms: cannot move right leg MRI thoracic spine:Please note that there are 4 lumbar-type vertebrae with hypoplastic ribs at T12. There are pedicle screws present at T6, T7, T10 and T11 bilaterally associated with interconnecting rods and multilevel laminectomies at the T7, T8, T9 and T10 there is a drainage tubing extending from the subcutaneous tissues into the laminectomy sites.Since the prior exams posterior vertebral mass previously involving predominantly left-sided posterior elements, epidural space and perivertebral space has been debulked. The spinal cord is no longer compressed at this time. There is encroachment of the left-sided neural foramina at the T8-9 and T9-10 due to neoplasm which is less impressive than on the prior exam. There are some associated encroachment of exiting nerve roots.There are some patchy signal changes within the spinal cord which were previously present and do not appear to have changed substantially in extent compared to this 12/2/2015 exam.There is some residual neoplastic tissue present at the origin of site of the tumor within the left posterior lateral aspect of the T9 and T8 vertebral body levels.The thoracic vertebral bodies are appropriate in the overall alignment and height. There is a left-sided pleural effusion present.Lumbar spine:Four lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. Hypoplastic ribs are present at T12. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is facet hypertrophy present this level as well as disc desiccation and a diffuse disc bulge. This appearance is stable compared to the prior exam.At L4-5 there moderate bilateral facet and ligamentum flavum hypertrophy present associated with a diffuse disc bulge and mild anterior subluxation of L4 on L5. There is partial effacement of fat at the lateral recesses bilaterally. Overall there is a mild degree of spinal stenosis present at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is disc desiccation and a minor disc bulge at this level. There are Schmorl's nodes at this level.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.Please note the infiltration of the thoracic vertebrae and lumbar vertebrae. There are 4 lumbar-type vertebrae present. There are hypoplastic ribs present at T12.2.Since the prior exam the patient is undergone multilevel laminectomies and posterior instrumentation in the lower thoracic spine where there has been tumor debulking. There is no spinal cord compression appreciated on the current exam. There is narrowing of the left-sided neural foramina at T8-9 and T9-10. Signal changes within the thoracic spinal cord were also present on the preoperative exam. These do not appear to have changed significantly compared to the 12/2/2015 exam.3.There are multilevel degenerative changes present lumbar spine which are worse at L4-5 where there is mild to moderate spinal stenosis.4.Left-sided pleural effusion.