Reason: evaluate for cord compression - 62 yo with recent C spine laminectomy complicated by fluid collection and MRSA bacteremia now with AMS, new LE weakness and supratherapeutic PTT c/f cord compression per neurosurgery History: AMS, dec LE strength, fever, supratherapeutic PTT Vertebral body heights in the cervical, thoracic, and lumbar spine are normal. Alignment is grossly maintained. There are postsurgical changes of cervical laminoplasty from C3 to C7. Degenerative changes are again seen in the cervical spine including T2 hyperintensity within the C3-C4 disc space with small disc extrusion as seen on recent MRI. There is mild spinal canal stenosis at this level without cord compression. Thoracic and lumbar spinal canal are also patent. There are postsurgical changes of spinal canal decompression and fusion at L4-L5. There is edema involving the T12 vertebral body with minimal irregularity and Schmorl's node involving the superior endplate, questionably worse since 12/6/2010. No significant loss of height. There is focus of T2 hyperintensity involving the dorsal spinal canal at the epidural space at L1-L2 which is not well evaluated on these limited sequences and may represent fluid; finding is nonspecific and may be from a degenerative, traumatic, or infectious basis.
1. This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No cord compression is identified.2. Postoperative changes of cervical laminoplasty for spinal canal decompression. Cervical spine is better assessed on recent MRI from 12/14/2015.3. Edema involving the T12 vertebral body, possibly related to minimal irregularity of the T12 superior endplate or trauma. No significant loss of height or osseous retropulsion. Small focus of T2 hyperintensity in the dorsal epidural space at the L1-L2 level which may be on a degenerative basis although other etiologies such as infection or blood products may also be considered in the appropriate clinical setting. There is no associated cord compression. Please note this is a limited study to exclude cord compression. Although there is no cord compression, if there is high suspicion for infection including epidural abscess, would recommend a dedicated MRI spine study with gadolinium. 