62-year-old male with and urinary incontinence. Evaluate for spinal cord compression. Exam is limited by motion. No cord compression is identified although a small posterior epidural fluid collection versus epidural thickening may be present within the lower lumbar spinal canal which is contributing to crowding of the thecal sac. Apparent cord signal abnormalities within the cervical and thoracic spine are most likely artifact. The vertebral bodies are appropriate in the overall alignment and height. There are multilevel degenerative changes involving the cervical spine especially spanning the C3-4 through C6-7 levels where there is mild to moderate spinal canal stenosis at these levels secondary to disc osteophyte complexes. The spinal canal is narrowed in this region and there may be some degree of chronic cord impingement. There is degenerative anterolisthesis of L4 on L5 and degenerative loss of disc height most prominently involving L4-5 and L5-S1 with disc bulges. Advanced facet arthropathy is seen at L4 and L5 with facet effusions and substantial edema within the facet complexes and pedicles. There is at least moderate neuroforaminal narrowing involving the right L4-5 level. The superior pole of the left kidney, which is only partially visualized, seems subjectively enlarged and abnormal in shape.
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 although a small posterior epidural fluid collection versus epidural thickening may be present within the lower lumbar spinal canal which is contributing to crowding of the thecal sac. Dedicated lumbar MRI imaging is recommended for further evaluation.Additional multilevel degenerative changes visualized within the cervical and lumbar spine are as described above. Advanced facet arthropathy at L4 and L5 is seen with significant edema in the marrow and surrounding soft tissues. While this could all be inflammatory and related to severe degeneration, the possibility of superimposed infection is not excluded.The superior pole of the left kidney seems subjectively enlarged and abnormal in shape for which dedicated renal imaging can be obtained if clinically warranted.